Turbinates of the Nose – Excision

About the Procedure

The Excision of the Turbinates of the Nose (anatomically known as Nasal Concha) is performed to reduce the size of enlarged turbinates - bony scroll-shaped structures lined with mucous membrane located on the sides of the inside of the nose. Turbinate surgery refers to the inferior turbinates, the largest of three pair in the nasal cavity. These structures play a critical role in respiration by directing the flow, speed, temperature, and humidity, of inhaled air, and there are specific conditions under which they must operate to maintain their processes. When an enlarged turbinate infringes upon the nasal opening, it interferes with the flow of inhaled air creating breathing difficulties in the patient as well as altering the biological process of the turbinates. The underlying cause of the enlargement may be allergies, chronic sinusitis, environmental irritants, deviated septum, injury, or previous nose surgery. An endoscopy is helpful in diagnosing the underlying cause and selection of the best procedure to use.

The one hour procedure is done in a hospital under general or local anesthesia and most patients are discharged the same day. After the surgeon enters the nasal cavity he or she may decide to cut across and completely through the turbinate closer to its base (total inferior turbinectomy) or closer to the inside of the nose (partial inferior turbinectomy). The incisions are sealed by cauterization and the cavity is packed to stop bleeding or oozing.

What to Know Before the Procedure

When a turbinate is enlarged or has swelled, there is an underlying cause which must be identified and corrected if possible. Because the role of these structures in respiration is so vital, all available treatments should be exhausted before surgery is chosen. Continued treatment of the initial cause is essential in preventing a recurrence.

Due to the vascularity of the insides of the nose, it bleeds easily during and after surgery. Therefore, it is of particular concern in this procedure. The condition has a tendency to return, especially when the initial cause is not properly treated, resulting in many patients undergoing a second or third procedure.

Preparation for this procedure includes a health assessment, blood work, instructions on medications, vitamins, or herbs to avoid for at least two weeks prior to and after surgery, and instructions on food and water intake prior to surgery. Plan in advance for a ride at discharge as post-operative pain medications may cause drowsiness. Assistance for the first day is recommended since pain and tiredness are the chief complaints during recovery.

What to Know After the Procedure

Patients are discharged the same day when there are no complications. They are advised to elevate their head for 24 to 48 hours and to use ice packs to reduce swelling and pain. Blood may ooze from the nose for a few days. The doctor will give instructions about the use of nasal sprays and rinses to keep the nasal cavities moist. Activities which put pressure on the nose, e.g., heaving lifting, sports, nose blowing, pulling clothes over the head, and vigorous tooth brushing must be avoided for two to three weeks. Work can be resumed according to the patient's comfort level and the physician's advice, especially for those with strenuous jobs.

If you Need to Travel Outside of your Local Hospital

Long-distance travelling for this medical procedure is an option provided there will be adequate time to allow the patient to rest and elevate their head for two days following surgery. An uncomplicated turbinate excision does not require a long recovery period. Discuss post-operative care, travel restrictions, and concerns with several doctors before making a decision on where to have this procedure performed.