Definition

The inside walls of the nose have 3 pairs of long thin bones covered with a layer of tissue that can expand. These bones are called nasal turbinates.

Allergies or other nasal problems can cause the turbinates to swell and block airflow. Surgery can be done to open blocked airways and improve your breathing.

Alternative Names

Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery; Nasal obstruction - 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 may have general anesthesia or local anesthesia with sedation, 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 may have general anesthesia or local anesthesia with sedation, so you are asleep and pain-free during surgery.

Radiofrequency or laser ablation:

• A thin probe is placed into the nose. Laser light or radiofrequency energy goes through this tube and shrinks the turbinate tissue.
• The procedure can be done in the health care provider's office using local anesthesia.

Why the Procedure Is Performed

Your provider 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
• Bleeding

Before the Procedure

Always tell your provider:

• 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 medicines that make it hard for your blood to clot.
• Ask your provider which medicines 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 you have been told to take with a small sip of water.
• Your provider 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 people 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. You may feel partly congested for a few weeks.

Your surgeon or 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 1 week.

It may take up to 2 months to heal completely.

References

Beswick DM, Ramakrishnan JB. Septoplasty and turbinate surgery. In: Scholes MA, Ramakrishnan VR, eds. ENT Secrets. 5th ed. Philadelphia, PA: Elsevier; 2023:chap 28.

Corren J, Baroody FM, Togias A. Allergic and nonallergic rhinitis. In: Burks AW, Holgate ST, O'Hehir RE, et al, eds. Middleton's Allergy: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 40.

Kridel RWH, Sturm A. The nasal septum. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 29.

Otto BA, Barnes C. Surgery of the turbinate. In: Myers EN, Snyderman CH, eds. Operative Otolaryngology Head and Neck Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 97.