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Enlarged Turbinates (Turbinate Hypertrophy)

Globally Recognized Teacher & Innovator of Nasal Surgery

Dr. Mobley has taught his surgical techniques internationally and has written numerous medical articles and book chapters on his innovations. Dr. Mobley is a national authority on Facial Plastic Surgery and is published in some of the leading teaching texts of our time:

The inferior turbinates are thin bony structures inside your nose covered by thick mucous membranes. Turbinate reduction surgery is a very common procedure that is done alone or as an additional part of surgery to help restore normal nasal breathing.

To better understand what turbinate reduction surgery really is, you first have to understand exactly what the inferior turbinate is and what we accomplish when we surgically reduce the size of the inferior turbinate.

The inferior turbinate is an elongated, almost tubular structure inside of the nose that is intended to humidify, warm, and filter air as it passes through the nasal passageway. The inferior turbinates are important structures, especially in Utah’s dry and cold environment and as such, a conservative reduction of this structure is preferred. Over aggressive resection can cause other derangements in nasal breathing.

Diagnosis of turbinate hypertrophy can almost always be made during your initial evaluation by Dr. Mobley at the Utah Center for Better Nasal Breathing. A complete history, focusing on nasal congestion, medications, and allergies will often begin to suggest the diagnosis of inferior turbinate hypertrophy. An anterior (speculum) nasal exam and sometimes a “scope” exam will finalize the diagnosis for most patients. While CT scans can play an important role in diagnosing problems in nasal function they are rarely used for the sole purpose of diagnosing enlarged inferior turbinates.

It is important to remember that inferior turbinate enlargement is more commonly “part” of the reason the nose is feeling blocked, less commonly the sole cause for a poorly breathing nose. Other conditions such as septal deviation, chronic allergies, and internal valve collapse are commonly seen along with enlargement of the inferior turbinates.

There are many first line medical treatments that patients can try to medically reduce the size of the inferior turbinates. Nasal steroids, nasal antihistamines and decongestants can be used to treat inferior turbinate hypertrophy. These medications help to reduce the swelling and improve nasal breathing. The downsides of these medications are that they can be quite drying to the nose and some patients simply don’t like the idea of needing to squirt a medication in their nose on a daily basis. There is nothing wrong with trying medical therapy before considering surgical options. For patients that do not respond to medications, it may be necessary to perform a simple surgery to reduce the size of your inferior turbinates.

The surgery to reduce the size of the turbinate is referred to as a ‘turbinoplasty’ by some surgeons. Others refer to this as ‘submucous resection’ of the turbinate. There are a wide variety of surgical procedures intended to treat turbinate hypertrophy and at the Utah Center for Better Nasal Breathing our philosophy is to choose the best procedure for each patient- avoiding a “one size fits all” approach to restoring normal nasal breathing.

All turbinate reduction techniques are performed through the nostrils so there is no external incisions or scarring. Some involve an accurate “shaving” device to “debulk” some of the interior tissue of the inferior turbinate. This technique does not require temporary tissue injury associated with cautery and also preserves the physiologically important outer layer of the inferior turbinate.

It is important to remember that inferior turbinates are both bone and thick mucous membrane. In some patients, this bony component to enlargement of the turbinate has to be addressed as well. In these cases, the inferior turbinate can be approached by making a small incision along the front border to expose the underlying bone. The bone can then be partially resected and/or moved out to the side to help improve the nasal breathing- a process called “outfracture”.

At the Utah Center for Better Nasal Breathing, we approach each patient as an individual and will recommend the technique or techniques appropriate for their particular case of inferior turbinate enlargement.