Richmond’s Sinus and Allergy Specialists

Enlarged Turbinates

The nasal turbinates are baffles along the each side of the nose that warm, humidify, and clean the air before it reaches your lungs.  This function is so important, that we become quite uncomfortable when the nose is congested, forcing us to breathe through the mouth. Three turbinates line each side of the nasal cavity.  They alternately swell or decongest to control the humidity and temperature of the air reaching the lungs. When they are swollen from allergies or sinus disease, correction of the underlying problem usually restores normal function.

Surgery is recommended primarily for bony overgrowth of the turbinates. This usually occurs in conjunction with a nasal septal deviation to the opposite side. At the time of a nasal septal reconstruction, the enlarged turbinate is trimmed to make room for the septum to swing to the middle.  If the turbinate is not severely overgrown, it might simply be fractured to the side, making more room for air passage.

Submucosal cautery, Coblation, Laser and other methods of heating the turbinate are sometimes offered to patients who have failed medical management of allergies or chronic sinusitis. Under local or general anesthesia, the vascular tissue under the mucosa membrane is heated to create shrinkage and decrease the tendency to swell.  Studies show improved breathing for up to one year after treatment.  Turbinate enlargement from swelling or mucosal hypertrophy (proliferation of the blood vessels and glands) may recur if the underlying disease is not treated.

Removal of the turbinates can cause a dry nose and should be avoided if possible.  The inferior turbinates were commonly removed in years past, leaving patients with severely dry noses, known as empty nose syndrome. An empty nose is not only unpleasantly dry, but ironically it feels obstructed. The empty nose can also develop a foul smelling infection known as ozena.

Nasal & Sinus Surgery Postoperative Instructions