Here in this article lets understand What are Turbinates in the nose, Enlarged turbinates surgery, Causes of turbinate hypertrophy, What are the symptoms of Enlarged turbinates? and Diagnosis, Enlarged turbinates treatment.
What are the turbinates or fleshy masses?
Turbinates are very normally occurring structures in every human being. There are three pairs of turbinates, Inferior turbinates, Middle turbinates, and Superior turbinates.
These turbinates have three functions in breathing. If we breathe through the nose, they add warmth to the air. They add moisture to the air we breathe through the nose. The turbinates produce a thin slimy fluid called mucus.
This mucus traps the dust particles, pollutants, and microorganisms like bacteria and viruses. By trapping these microorganisms, it initiates the immune response to these microorganisms. So these turbinates, when they enlarge in size, they start causing issues. The enlarged turbinates are also called hypertrophic turbinates.
What are the causes for the Enlarged Turbinates?
The first most common cause is allergies when a patient exposed to an allergen what he’s allergic to the inside of his nose gets inflamed. This inflammation causes the turbinates to get enlarged or hypertrophied.
When a patient exposed to irritants such as cigarette smoke the terminates get enlarged in patients having sinusitis when the pus drains out of the sinuses and flows over the turbinates the turbinates get inflamed and get enlarged in size some patients whenever they get nose block they go to a pharmacy they buy nasi veon or or driven nasal drops and when they put these drops they get relief from the nose block instead of understanding what is the cause for the nose block they start using these nasal drops for months and years together and this condition is called rebound rhinitis or rhinitis
In this condition turbinates get enlarged in pregnant women because of the hormonal changes the turbinates can get enlarged some children are born with enlarged turbinates and during aging as the age progresses the turbinates can enlarge in size these are the most common causes for the hypertrophy or enlargement of the turbinates.
What are the symptoms of Enlarged turbinates or Hypertrophic
Hypertrophic turbinates occupy a large amount of the nasal breathing space, patients experience nose block whenever there is nose block, the patient has to compensate by breathing through the mouth and this causes dry mouth chapped lips and bad breath from the mouth.
Patients having nose block and patients who breathe through the mouth during sleep because of the nose flop and the mouth breathing these patients can have slurring and sometimes associated sleep apnea, If there is coexisting allergy issues along with the hypertrophy terminates patients can experience recurrent sneezings itching in the nose, watering from the nose, itchy watery eyes, itchy throat and ears.
If the patient has co-existing sinusitis, his nose block will be even more severe. Patients will experience headaches, reduced sense of smell and taste post-nasal drip and congestion of fullness in the ears. In most of the cases along with the hypertrophy terminates, there will be deviated nasal septum allergies or sinusitis issues and because of this the ventilation to the ears gets affected. When the ventilation to the ears get affected there can be fluid formation in the middle ears or holes in the eardrum.
How to diagnose and treat enlarged or hypertrophic turbinates?
Whenever a patient comes to us with a nose block, we examine the nose under the headlight. Hypertrophic turbinates can easily be seen under headlight. Once we diagnose hypertrophic turbinates, we try to understand what is the reason behind enlargement of these turbinates. If we suspect allergies in the patient, we advise an allergic skin prick test. In this skin prick test, we try to identify the allergens which are causing the allergy issues for the patient, and to what extent he’s allergic to that substance. Based on that, we might advise complete avoidance or cyclic rotation of these allergens.
If we suspect sinus issues for the patient, We advise a CT scan for the nose and sinus.If we find sinus issues on the CT scan, we can treat him medically or surgically. And this changes on a case to case basis.
Patients having rebound rhinitis or rhinitis medicamentosa, where patients unknowingly abuse the nasal drops, we advise the patients to immediately stop using the nasal drops. Some patients get so habituated and dependent on the nasal drops that they cannot stop them suddenly. For these patients, we advise them to use the nasal drops in an alternating fashion. That is one night they’ll be putting the nasal drops only in the right nose. And the next night, they’ll be putting the nasal drops only in the left nose. In this way, over the next one week or 10 days, we can break the dependency of the patient on the nasal drops and make him stop the nasal drops completely.
In the patients who are exposed to active or passive smoking, we advise the patients to stop smoking completely and to stop exposing themselves to the smoke fumes which come from the other people smoking the cigarettes.
For pregnant women, children born with enlarged turbinates or people who develop enlarged turbinates because of aging, we advise medication like saline nasal drops, saline nasal sprays, antihistamines and steroid nasal sprays.
For some patients, even on taking care of the root cause and giving good medical treatment, they do not get good relief from the nose block.For these patients, we advise surgical management.
There are two surgical methods which are primarily performed for dealing with the enlarged turbinates.
- In the first method, we apply laser, coblator or cautery at different points along the length of the turbinate and we try to shrink the tissue of the inferior turbinate. In this way, by shrinking the turbinate tissue, we can produce more space in the nose.
- The second and more advanced technique is the turbinoplasty.In this surgical method, we give an incision, that is we give a cut along the entire length of the inferior turbinate. We elevate the mucosa, that is the skin overlying the inferior turbinate. We remove the excess bone and the soft tissue, and we reposition the skin or the mucosa over the cut end of the turbinate. This gives more control over the amount of tissue we remove and also gives long lasting results.
Even after doing either of the surgical methods, it is important to understand the root cause, which primarily caused the enlargement or the hypertrophy of the turbinates and we have to keep addressing it even after the surgery.
Hope we could explain in detail about the turbinates, why they enlarge in size, what symptoms are seen because of the enlarged or hypertrophied turbinates, and how we diagnose and treat this condition. If you are looking for enlarged turbinates surgery in Hyderabad or know the Turbinate reduction surgery cost India. Get an appointment with our best ENT doctor in Hyderabad, Dr. G V K Chaitanya Rao at Sinus Doctor.
Frequently Asked Questions about the Enlarged Turbinates or Hypertrophic
- In the first method, we apply laser, coblator or cautery at different points along the length of the turbinate and we try to shrink the tissue of the inferior turbinate. In this way, by shrinking the turbinate tissue, we can produce more space in the nose.
- The second and more advanced technique is the turbinoplasty. In this surgical method, we give an incision, that is we give a cut along the entire length of the inferior turbinate. We elevate the mucosa, that is the skin overlying the inferior turbinate. We remove the excess bone and the soft tissue, and we reposition the skin or the mucosa over the cut end of the turbinate. This gives more control over the amount of tissue we remove and also gives long lasting results.
- Patients experience nose block
- Patients experience in difficulty in breathing
- Patients can experience recurrent sneezings itching in the nose
- Watering from the nose
- Itchy watery eyes
- Itchy throat and ears
Patients having nose block and patients who breathe through the mouth during sleep because of the nose flop and the mouth breathing these patients can have slurring and sometimes associated sleep apnea, If there is coexisting allergy issues along with the hypertrophy terminates patients can experience recurrent sneezings itching in the nose, watering from the nose, itchy watery eyes, itchy throat and ears.
Whenever a patient comes to us with a nose block, we examine the nose under the headlight. Hypertrophic turbinates can easily be seen under headlight. If we suspect sinus issues for the patient, We advise a CT scan for the nose and sinus.
