Turbinate surgery

Description

There are several types of turbinate surgery:  

Turbinectomy:

• All or part of the lower turbinate is taken out. This can be done in several different ways, but sometimes a tiny, high-speed device (microdebrider) is used to shave off the extra tissue.
• The surgery may be done through a lighted camera (endoscope)that is placed into the nose.
• You will have general anesthesia, so you are asleep and pain-free during surgery. 

Turbinoplasty:

• A tool is placed in the nose to change the position of the turbinate. This is called the outfracture technique.
•  Some of the tissue may also be shaved off.
• You will have general anesthesia, so you are asleep and pain-free during surgery.

 Radiofrequency or laser ablation:

• A thin probe is placed into the nose. Laser light or radioenergy goes through this tube and shrinks the turbinate tissue.
• The procedure can be done in the doctor’s office using local anesthesia.

Why the Procedure is Performed

Your doctor may recommend this procedure if:

• You have trouble breathing though your nose because the airways are swollen or blocked.
• Other treatments such as allergy medicines, allergy shots, and nose sprays have not helped your breathing.

Risks

Risks for any surgery are:

• Allergic reactions to medicines
• Breathing problems
• Heart problems
• Bleeding
• Infection

Risks for this surgery are:

• Scar tissue or crusting in the nose
• A hole in the tissue that divides the sides of the nose (septum)
• Loss of feeling in the skin on the nose
• Change in the sense of smell
• Fluid buildup in the nose
• Return of the nasal blockage after surgery

Before the Procedure

Always tell your doctor or nurse:

• If you are or could be pregnant
• What drugs you are taking, including medicines, supplements, or herbs you bought without a prescription
• If you have more than 1 or 2 alcoholic drinks a day

During the days before your surgery:

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
• Ask your doctor which drugs you should still take on the day of your surgery.

On the day of your surgery:

• You will be asked not to drink or eat anything after midnight the night before your surgery.
• Take the medicines your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

Many people have good short-term relief from radioablation. Symptoms of nasal blockage may come back, but many patients still have better breathing 2 years after the procedure.

Almost all people who have turbinoplasty with a microdebrider will still have improved breathing 3 years after surgery. Some do not need to use nasal medicine anymore. 

Outlook (Prognosis)

You will go home on the same day as surgery.

You will have some discomfort and pain in your face for 2 or 3 days. Your nose will feel blocked until the swelling goes down.

The nurse will show you how to take care of your nose during your recovery.

You will be able to go back to work or school in 1 week. You can return to your normal activities after 3 weeks.

It may take up to 2 months to heal completely.

Alternative Names

Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery

References

Joe SA, Patel S. Nonallergic rhinitis. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 46.

Chhabra N, Houser SM. The surgical management of allergic rhinitis. Otolaryngol Clin N Am. 2011;44:779-795. 

Update Date: 9/4/2012

Updated by: David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc., and Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington.