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St. Maarten Medical Center
Ear, Nose and Throat Specialist Outpatient Department
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The turbinates are structures on the side wall of the inside of the nose. On both sides there are 3 turbinates They project into the nasal passages as ridges of tissue. The turbinates help warm and moisturize air as it flows through the nose. The lower or inferior turbinates can block nasal airflow when they are enlarged. The pictures below demonstrate how the inferior turbinates can block airflow when they are enlarged and touch the nasal septum.
The turbinates are made of bone and soft tissue. The soft tissue can become enlarged. In most patients, enlargement of the soft tissue part of the inferior turbinate is the major problem when the turbinates become swollen.
The diagnosis of enlarged inferior turbinates can be made by your doctor with a thorough evaluation of your symptoms and nasal examination. Your doctor may perform a procedure in the office called a nasal endoscopy to diagnose the cause of your nasal obstruction.
After making the diagnosis, your doctor can discuss treatment options for you. If the turbinates are swollen, your doctor may recommend medication for you, like specific nasal spray. For many patients, medications can help reduce the size of the turbinates and can help improve their nasal obstruction. If you have troublesome symptoms even after using medication, you may be a candidate for surgery to shrink the size of your turbinates.
There are many ways to shrink the size of the turbinates. Surgery is typically called turbinate reduction or turbinate resection. Surgery can be performed either in the office or in the operating room. In many instances, turbinate surgery and septoplasty are performed at the same time. Occasionally, turbinate tissue will re-grow after turbinate surgery and the procedure may need to be repeated. This is preferable to the situation of totally removing the turbinate.
You may hear of many different terms being used when it comes to surgery for the turbinates. Some of these methods shrink the turbinates without removing the turbinate bone or tissue. These methods include cauterization, coblation, and radiofrequency reduction. In each of these methods, a portion of the turbinate is heated up with a special device. Over time, scar tissue forms in the heated portion of turbinate, causing the turbinate to shrink in size.
With some of the other procedures, a portion of the turbinate is removed. It is important that enough of the turbinate be left intact so that the turbinate can warm and humidify the air that is flowing through the nose. A procedure called sub mucosal resection is a common technique used to treat enlarged turbinates. With this procedure, the lining of the turbinate is left intact, but the “stuffing” from the inside of the turbinate is removed. As the turbinate heals, it will be much smaller than before surgery.
In some instances, like resection of part of the nasal turbinate under general anaesthesia packing may be placed in your nose after surgery.
If nasal packing is used , the packing will be removed one day after surgery. You can expect to have a little pain, nasal stuffiness, and mild nasal drainage after your surgery. Pain is generally mild with this type of surgery and is well controlled with pain medication like paracetamol. The stuffiness typically results from swelling after the procedure, and typically starts to improve after the first week. You may have drainage of some mucus and blood from your nose after surgery. This is a normal part of the healing process.
You may be asked to use saline sprays or irrigations after your surgery. Please check with your surgeon about any post-operative care you will need to perform to allow your nose to heal properly. 2 to 3 weeks after surgery the ENT surgeon will check your nose to see if the breathing has improved.