Nasal Turbinate Hypertrophy

Individuals can manage their symptoms by reducing allergens in the home. This can be done by:

• • • Vacuuming carpets, pillows, drapes and furniture to remove dust
    • Placing a dust-proof cover over the mattress to protect the mattress from dust mites
    • Avoiding smoking
    • Using specially formulated cleaners to keep the home free of mold and mildew
    • Using a high-efficiency particulate air (HEPA) filter indoors
    • Keeping pets out of the bedroom or house to limit exposure to pet dander irritants

Taking the following medications and at-home treatments can also help manage turbinate hypertrophy:

• • • Cetirizine (Zyrtec) or loratadine (Claritin, Allegra)
    • Oral decongestants, such as pseudoephedrine or phenylephrine
    • Nasal decongestants to relieve nasal swelling (on a temporary basis)

Patients who don’t respond to medication and at-home treatments may need surgery. The three main surgical approaches to addressing turbinate hypertrophy include:

Inferior turbinate bone resection (ITBR). During this procedure, a portion of the bone of the inferior turbinates is removed to improve airflow in the nose.

Partial inferior turbinectomy (PIT). During this procedure, the soft tissue of the inferior turbinate is removed.

ITBR and PIT are both performed in an operating room while the patient is under general anesthesia. Patients should avoid eating and drinking after midnight, the day of the surgery. Patients should also refrain from taking aspirin or ibuprofen to minimize their risk of bleeding.

During the surgery, the surgeon will cut into the turbinate to remove some of the bone and use a special device to shave off some tissue. These two types of operations are usually performed on individuals with severe cases of turbinate hypertrophy.

Submucosal diathermy (SMD). This procedure involves using a diathermy needle to apply heat energy that will cause scar tissue to form and reduce the turbinates’ size. The entire procedure takes about 10 minutes and can be performed under local anesthesia that is injected into the nasal tissues. This type of surgical approach is commonly used to treat moderate cases of turbinate hypertrophy.

The exact type of procedure performed will depend on the patient’s condition. The challenge of turbinate surgery is improving airflow without completely removing the turbinate, as doing so could cause a dry, stuffy nose on a permanent basis.