Turbinate Hypertrophy and Nasal Congestion
Nasal congestion is a very common condition, but persistent nasal blockage may be a sign of more serious issues. Enlargement of the inferior turbinates is one of the main causes of nasal obstruction.
Turbinates are structures located on the lateral walls inside both nostrils, extending from front to back, composed of vascular tissue surrounding bone. Since they play an important role in regulating airflow, warming and humidifying air, and filtering particles, complete removal is not preferred.
They may enlarge as a reaction to allergies, sinus infections, sensitivity to cigarette smoke, chemicals, air pollution, or changes in temperature or consumption of hot/spicy foods, especially at a certain age. Turbinates that are excessively large and cannot be reduced with treatment can be surgically reduced.
What is a Turbinate?
Also known as nasal conchae, turbinates are important structures that play an active role in regulating respiratory function by warming and humidifying the air taken in through the nose.
Among the public, turbinates are often confused with adenoids or the nasal septum (the central bone). However, adenoid-related conditions are commonly seen in childhood, while turbinate issues typically arise in adulthood.
There are generally three turbinates on each side of the nose: superior, middle, and inferior turbinates. They are composed of soft tissue and bone.
Problems in the turbinates usually arise from enlargement or structural/developmental abnormalities in these two components. Treating turbinate issues significantly improves the patient’s quality of life and prevents other health problems.
How Are Turbinate Disorders Diagnosed?
A physical examination is usually sufficient to diagnose inferior turbinate hypertrophy. In some cases, the hypertrophy may be located at the posterior end of the turbinate, not the front. Therefore, the entire turbinate structure should be examined via endoscopic evaluation.
Middle turbinate issues can often be detected through physical examination, but CT scans are typically required for a definitive diagnosis. CT also provides important information about the sinuses, aiding in treatment planning.
How Is Turbinate Surgery Performed?
The most modern techniques in turbinate surgery today are radiofrequency reduction and microdebrider reduction. Due to its traumatic nature, laser surgery is not commonly used for this purpose.
If radiofrequency is performed alone, it is a same-day procedure done under local anesthesia. After numbing the nasal passages, the process is performed quickly and painlessly. No nasal packing is used, and the patient can return to daily life the same day.
Microdebrider surgery may require general anesthesia. After the procedure, light nasal packing that doesn’t completely block the nose is used for 2 days. These surgical methods reduce enlarged turbinates, restoring healthy nasal function. In turbinoplasty, a small incision is made in the turbinate to remove part of the bone and soft tissue.
Radiofrequency and microdebrider methods are mainly used when the turbinate tissue is significantly enlarged. If the bone is very large, turbinoplasty may be more effective. However, bone enlargement is rare, so turbinoplasty is seldom needed.
In both surgeries, the likelihood of turbinate regrowth is very low (less than 5%). However, if the underlying causes (allergies, smoking, pollution) persist, occasional medication may be required.
Tonsil Surgery
Tonsils are important organs located on either side of the tongue base in the oral cavity, helping trap microbes and producing defense substances. Tonsil-related issues are most commonly seen in children. Infections in children often cause tonsils to swell and enlarge. In such cases, tonsil surgery may be necessary.
When Should Tonsils Be Removed?
Tonsils should be removed if they frequently become infected in children. If a child has more than 3–5 tonsil infections per year, tonsillectomy may be needed. Surgery may also be required if the patient has a tonsil abscess or suspected malignancy. Other conditions requiring tonsillectomy include:
- Difficulty breathing or swallowing,
- Foul breath due to tonsil infections,
- Rheumatic heart disease, valve infections, or kidney inflammation,
- Tonsil enlargement causing jaw structure distortion.
If a child experiences nasal breathing difficulty and snoring, the adenoids may also need to be removed.
At What Age Is Tonsil Surgery Performed?
Tonsil issues can occur at any age, but they are most common in childhood. If adults have recurrent throat infections, surgery may be necessary. There is no upper age limit. For children, unless urgent, surgery is generally delayed until age 3–4.
How Is Tonsil Surgery Performed?
Tonsillectomy is a comfortable and highly successful procedure. It is performed when tonsils frequently become infected and cause illness. In some cases, partial reduction of the tonsils is done.
The entire tonsil is usually removed. However, since similar tissues exist in the Waldeyer’s ring in the throat, no functional deficiency arises. This surgery has been performed for over 120 years and thoroughly studied. It does not cause significant immunity issues or increase cancer risk.
In some cases where the tonsils are simply too large, partial reduction is done without full removal. This preserves some immune function.
Today, tonsillectomy can be done using cold steel dissection, monopolar/bipolar cautery, laser, thermal welding, or plasma ablation techniques.
Postoperative pain is minimal in children. Bleeding, pain, and feeding recovery vary little among techniques.
What Is the Recovery Process After Tonsil Surgery?
Recovery after tonsillectomy depends on the surgery’s success, the patient’s condition, and age. Patients are typically discharged 3–4 hours post-op under general anesthesia, though some may stay overnight. Recovery is usually quick.
Full healing takes about 2 weeks. Following medication, diet, and rest recommendations during this time is crucial.
Post-Tonsillectomy Care Instructions
The most important thing after surgery is rest on the day of the operation. For 7 days post-op, patients should avoid hard foods, carbonated and alcoholic beverages, and strenuous activity.
Following all instructions is vital for fast recovery. Patients should:
- Eat soft, liquid foods for the first 1–2 weeks,
- Avoid hot foods in the first week,
- Consume cold items like water, milk, or ice cream,
- Avoid alcohol and tobacco until healed,
- Take all prescribed medications regularly,
- Resume exercise only after full recovery,
- Bathe with lukewarm water,
- Attend all follow-up appointments.
Nasal Turbinate Surgery
The nose is one of the most vital organs for a healthy and high-quality life. Proper breathing is essential for the entire body’s function.
If a person breathes 50% less due to internal nasal structure issues, their energy and immunity may also decrease by 50%. One of the most serious causes of nasal obstruction is turbinate hypertrophy.
What Problems Does Turbinate Hypertrophy Cause?
Turbinate issues can have many causes. If they are excessively large, serious problems may arise.
These include nasal obstruction, snoring during sleep, frequent throat infections, and waking up tired—significantly reducing quality of life.
Who Is Affected by Turbinate Problems?
Turbinate problems are among the most common causes of breathing difficulty. Every person has turbinates, but if they’re too large, they hinder breathing.
Turbinate swelling is more common in those with allergies, deviated septum, or cartilage issues. Common symptoms include:
- Difficulty breathing,
- Runny nose and itching,
- Watery, itchy eyes,
Frequent sneezing, etc.
How Is Turbinate Surgery Performed?
Turbinate surgery is performed under general anesthesia. The turbinates are reduced to the smallest possible size by specialists.
Patients typically experience significant relief in their nostrils after surgery. Procedures usually last 20 minutes to 1 hour.
Depending on the patient’s condition, surgery duration may vary. It can also be combined with rhinoplasty. Patients are generally discharged the same day. Resting for one week aids in rapid recovery.
Is Turbinate Surgery Difficult?
Turbinate surgery is usually simple and quick. It is rarely done alone, often combined with septoplasty, sinus, or cosmetic nasal surgeries. When done alone, it causes no post-op pain.
Patients are usually discharged the same day. Nasal packing is rarely required. Nasal congestion lasts for a week, then clears. Internal healing completes in about a month. There is no change in external appearance.
Turbinates, also known as nasal conchae, can become enlarged. During colds or flu, they swell and block airflow.
Patients with chronically swollen turbinates experience long-term nasal obstruction. They swell in cold and shrink in warm temperatures.
To reduce turbinate size, laser or radiofrequency may be used. Laser emits energy inside the nose to shrink tissue. Radiofrequency is more common and causes less tissue damage. It is one of the most effective long-term methods to improve quality of life.
Can Turbinate Enlargement Be Treated with Medication?
Turbinate hypertrophy can be managed with sprays, but full recovery is rarely achieved through medication alone. Long-term use may cause dryness and irritation.
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