Nasal Turbinate Surgery

The nasal turbinates can cause problems with breathing, snoring and in some cases sinus problems. Over the years many procedures have been trialled on turbinates with different degrees of success in alleviating patient symptoms.

What techniques have been used to treat enlarged turbinates?

The earliest techniques involved simply removing the inferior turbinates with a pair of long scissors. They did not grow back. In some patients this lead to a dramatic improvement in their breathing with no long term problems. In a small group of patients, significant dryness and sensitivity developed in the nose. This was sometimes associated with the development of crusting of dry mucus.

Other popular techniques involved cauterising (burning) or inserting a radiofrequency probe into the turbinates. These techniques were popular in the United States as they could be performed in the outpatient office and avoid expensive hospital fees. A “coblation” turbinoplasty falls into the category as well. A modest improvement could be obtained but many patients felt that the results were short lived or did not notice any improvement at all.

The word “turbinectomy” means to completely remove (or cut off) the turbinate. The word “turbinoplasty” means to reshape the turbinate. Note that there are actually four turbinates in each side of the nose – the supreme, superior, middle and inferior. This article relates to the inferior turbinates. Other problems can also occur in the other turbinates.

PJ Wormald, a world renowned otolaryngologist (ENT Specialist) in Adelaide published the technique of the submucous resection of the inferior turbinates nearly a decade ago. This has now been used by otolaryngologists for some time and the results have stood the test of time.

The submucous resection of turbinates technique (also known as an inferior turbinoplasty)

In this technique a small incision is made at the front end of the inferior turbinate. The mucosa on one side is carefully lifted free of the bone and removed. The component of the turbinate bone that is protruding out into the nasal airway and causing problems is removed. The mucosa is then laid back down and curled into a new, small turbinate.

This technique preserves all the good functions of the turbinate – humidification of air, production of mucus, sensation of airflow. At the same time it creates an improvement in breathing (and snoring in some cases).

The main risk of surgery is temporary bleeding. The turbinates have a rich blood supply so there can be some oozing from the nose for a couple of days after the surgery. There is also a small risk of infection and temporary crusting.

The surgery is done endoscopically (key-hole) under general anaesthetic in a hospital. There are no external scars and no facial bruising. The patient satisfaction rate is very high with this procedure. Most patients report a significant improvement in breathing, sleep quality and their overall quality of life.

Dr Roth often performs a submucous resection of the turbinates as part of the treatment of snoring, sinus problems, breathing problems or during a rhinoplasty. You can read more about nasal surgery including rhinoplasty here.