For people who have chronic congestion, chronic sinus infections, chronic mouth breathing/snoring and/or chronic nosebleeds that don’t respond well to other treatments, something called turbinate reduction may be the best option. Turbinate reduction or trubinoplasty, which is really an umbrella term for a few different procedures, aims to open up your nasal passages to allow air to better flow through your nose and to reduce feelings of congestion. Recovery time depends on the severity of the condition, but in general, most patients heal in just a couple of days from this minimally invasive in-office procedure as long as they follow all post-operative care guidelines.
What Is Turbinate Reduction
The turbinates are structures (you have three per side – superior, middle and inferior turbinates) in your nose that helps create humidity in your nose and helps purify or filter the air that you breathe in. Each turbinate structure has a bony center covered in vascular tissue and mucous membranes, and it’s that tissue and membrane that can swell in response to a number of conditions. When the inferior turbinate tissue swells, it can block off the air passage in your nose. If you also have a deviated septum, in which the central cartilage that forms a wall between your nostrils veers to one side, any swelling of the turbinate tissue can have a more pronounced effect on your breathing.
What you think of as congestion is not always due to your nose actually being “stuffy.” You don’t necessarily have a bunch of dried mucus or boogers plugging up your nose. Much of the time, the congestion is due to the swelling of that nasal tissue along the turbinates. When you take a decongestant, the medicine makes blood vessels contract, reducing the swelling along these turbinates.
Turbinate tissue can be enlarged on its own, or it can be a side effect of allergies, colds/URIs, sinus infections, irritants (smog, pollution, fires, smoking, vaping, marijuana use) as well as OTC sprays like Afrin and more. Enlarged turbinates can lead to snoring and blocked nasal passages when you sleep, and as a secondary side effect, you could experience sleep apnea. This can lead, in turn, to headaches, drowsiness, moodiness, and even elevated risks of conditions like cardiac problems. Leaving enlarged turbinates alone and just “dealing with” congestion can have some serious consequences.
When other treatments like sprays like Flonase or Nasacort as well as saline rinses don’t take care of swollen turbinate tissue, minimally invasive surgical reduction is a permanent treatment option for many affected patients. Turbinate reduction can be done as a stand-alone procedure in the office or with balloon sinuplasty or with septum surgery. The goal is to open up the nasal passages so that air flows freely without blockages.
What Turbinate Reduction Involves
Turbinate reduction is really the goal, and the procedure can vary depending on your specialist. However as a leading nose and sinus surgeon, Dr. Alen Cohen specializes in the most advanced and minimally invasive treatment for his patients needing turbinate reduction that can produce permanent and long-term results. As such he most often recommends in-office submucous resection of the turbinates under local anesthesia.
During this procedure the nasal tissues are topically numbed in the office for about 15-20 minutes and once fully anesthetized, a very small 2-3mm microdebrider is inserted inside the inferior turbinates and the bone is submucousally resected, thus reducing the turbinates from sausages blocking the nasal passage to pancakes which can’t block the passages. The surface of the inferior turbinates which is respiratory epithelium continues to function and filter the air but it can no longer block the nasal passages. This is a permanent technique which reduces congestion significantly for patients. It also prevents issues with crusting, dryness, nosebleeds and empty nose syndrome which can develop from other forms of turbinate reduction.
Recovering From Turbinate Reduction
This in-office minimally invasive procedure is extremely easy to recover from for most patients. It entails regular saline irrigation or spray of the nasal passages for about 2-4 weeks until the tissues have fully healed and all scabs and mucus in the nose have cleared. There never really is any pain or problems with your sense of smell when this procedure is performed by Dr. Cohen. Most patients resume normal activity the next day after the procedure, however blowing your nose and exercise are to be avoided for 3 days following the procedure.
Initially after the procedure you could have minor bleeding, so you’ll need cotton balls in your nostrils that will need to be changed frequently for the first 24 hours. After that no dressing or significant care is required except regular saline rinses or sprays. The first few days after the procedure, patients usually report congestion and mild sinus pressure like having a cold. However after the first 3-5 days, most of those sensations resolve and patients begin to report significantly improved breathing and sleeping. Full results are seen 3-4 weeks after the procedure when all the tissues have healed and all crusts in the nose have resolved. Most patients are ecstatic over the results at that time and report wishing having done the procedure years earlier with Dr. Cohen if they knew how simple it was!
If you have chronic nasal congestion, runny nose, postnasal drip, sinus headaches, sinus infections or have noticed symptoms like snoring, visit the Southern California Sinus Institute for an evaluation. Dr. Alen N. Cohen is a leading nose and sinus surgeon in Southern California, and offers consultations and procedures to help reduce turbinates and improve your ability to breathe through your nose permanently. Contact us to schedule an appointment.
