What are the turbinates?
The nasal turbinates are structures inside of the nose that regulate airflow through the nose, and aid in warming, humidifying, and filtering air. There are inferior, middle, and superior turbinates, with one of each on the inside of each side of our noses. The inferior turbinates play the largest role in airflow through the nose, and when they become enlarged (hypertrophy), this can cause difficulty breathing through one or both sides of the nose. Inferior turbinate hypertrophy is a very common condition, which is primarily caused by chronic exposure to allergens, pollutants, chronic sinus infections, and some medications.
What are symptoms of inferior turbinate hypertrophy?
The primary symptom of inferior turbinate hypertrophy is difficulty breathing through the nose. If you have ever had a cold and felt your nose swell shut, you were experiencing acute inferior turbinate swelling from the reaction to the virus. It is common that the congestion from inferior turbinate hypertrophy comes and goes, and often switches from side to side. The reason for this is that the inferior turbinates regularly take turns swelling on one side while shrinking on the other side. This pattern switches every 4 hours for all of us, and we don’t realize it. However, if the inferior turbinates become enlarged, you might begin to detect that sometimes one side of your nose seems more open, and then later on, it will switch and the other side is more open.
How is inferior turbinate hypertrophy diagnosed?
This condition is usually diagnosed with nasal endoscopy. Here at the Charleston Sinus Center, when you see one of our ENT specialists for congestion, the nasal endoscopy is part of your visit, and the diagnosis is made. In some cases, if the hypertrophy is very severe, the inferior turbinates can be seen by just shining a light into the nostrils, and the enlarged turbinates can be seen as reddish-pink structures that are located just inside the nostrils on both sides.
What is the initial treatment of inferior turbinate hypertrophy?
Inferior turbinate hypertrophy can respond very well to use of nasal sprays. Generally, the best results are obtained from a combination of an intranasal steroid spray and an intranasal antihistamine spray. Oral antihistamines and regular nasal saline rinses can also be helpful.
Why Choose Us?
- Board-certified ENT & sinus specialists
- State-of-the-art endoscopic technology
- In-office minimally invasive options like Balloon Sinuplasty
- Comprehensive care plans: diagnosis, surgery, and long-term management
- Proven results: 85% success rate with sinus surgery
What are the surgical treatment options for inferior turbinate hypertrophy?
If medical therapy fails to adequately improve your congestion from inferior turbinate hypertrophy, surgical reduction is a highly effective treatment. A small cut is made at the front of each inferior turbinate, and a specialized instrument is used to remove approximately one-half of the internal tissue of each inferior turbinate. This creates more space for air to flow through the nose, while preserving the normal functions of the inferior turbinates. Because this procedure is very straightforward, it can be performed either in the office under topical anesthesia, or in the operating room under general anesthesia. Because inferior turbinate hypertrophy is so common, surgical reduction is often performed along with a deviated septum surgery or with sinus surgery. However, if the enlarged turbinates are the primary cause of breathing troubles, or if a patient wants to have a small procedure without general anesthesia, an in-office inferior turbinate reduction can be a very effective treatment for nasal congestion.
Frequently Asked Questions
What is a concha bullosa?
A concha bullosa is an enlarged middle turbinate. It is caused by development of an air pocket within the middle turbinate during growth of the nasal structures in the womb and childhood, and is essentially a normal variant of the nasal anatomy.
What are symptoms of a concha bullosa?
Not everyone who has a concha bullosa has any symptoms. However, for some people, since a concha bullosa decreases the space for mucus to drain from the sinuses and for air to flow through the nose, it can cause recurrent sinus infections or chronic nasal congestion.
How is a concha bullosa treated?
If a concha bullosa is causing symptoms, it can be surgically removed, which relieves the sinus and nasal obstruction it was causing. This procedure, called a concha bullosa resection, is most often done in combination with either FESS or deviated septum surgery.