The nasal turbinates are long, narrow passageways that help to warm and moisten the air that flows in through the nose. The turbinates are also called the nasal conchae. If the turbinates are too large, they can actually block airflow. Doctors call this condition turbinate hypertrophy. This condition can cause breathing problems, frequent infections, and nosebleeds.
Some people have three while other people have four. Most people have superior, middle, and inferior turbinates. Enlargement of the inferior and middle turbinates most commonly causes turbinate hypertrophy. Both over-the-counter and surgical treatments can treat turbinate hypertrophy.
Turbinate hypertrophy makes it harder for you to breathe through your nose. Some of the additional symptoms include:
- altered sense of smell
- dry mouth upon awakening, which happens when you sleep with your mouth open because you can’t breathe through your nose
- forehead pressure
- mild facial pain
- prolonged nasal congestion
- runny nose
The symptoms of turbinate hypertrophy are very similar to those of a cold that won’t seem to go away.
Turbinate hypertrophy is also linked to a condition called septal deviation. Both conditions produce similar symptoms. A septal deviation occurs when the line of cartilage between the nostrils isn’t straight and blocks airflow. While most people don’t have a perfectly straight nasal septum, a very deviated or crooked septum can obstruct the airway and make you feel like you can’t breathe.
A doctor may have to order special imaging scans, such as a computed tomography (CT) scan, to identify whether the problem is turbinate hypertrophy or septal deviation. It’s also possible to experience both conditions at once.
Turbinate hypertrophy can be acute or chronic. Some of the most common causes of the condition include:
- chronic sinus inflammation
- environmental irritants
- seasonal allergies
Each of these conditions can cause the bone itself or the soft tissue of the turbinates to enlarge and swell. Many people with turbinate hypertrophy have a family history of allergic rhinitis.
A doctor will usually recommend at-home treatments to see if the nasal turbinates can shrink. Reducing the amount of allergy-causing dust, pet dander, and mold can reduce allergy symptoms while other treatments can ideally help shrink the turbinates.
Reducing allergens in the home
One way to help treat symptoms of turbinate hypertrophy is to limit your exposure to environmental allergens. Here are some tips to help you achieve that:
- Make every effort to remove excess dust and pet dander from the home. This includes vacuuming carpets, pillows, drapes, and furniture to remove dust.
- Place fabric-covered toys in freezer bags and leave in the freezer for 24 hours. This can help to kill allergy-causing dust mites.
- Protect your mattress from dust mites by placing a dust-proof cover over the mattress.
- Refrain from smoking, especially indoors.
- Remove mold and mildew with specially formulated cleaners, especially in basements, bathrooms, and kitchens.
- Use a high-efficiency particulate air (HEPA) filter indoors. This filter can help to eliminate a significant amount of irritating dust in a room. The most effective place to use an air filter is in a bedroom, as it’s where you sleep. If you have indoor pets, keeping them out of your bedroom can help to reduce pet dander irritants.
Medications and at-home treatments
In addition to reducing allergens in the home, there are medications and at-home treatments that can help turbinate hypertrophy. These include:
- Taking medications to reduce seasonal allergies, such as cetirizine (Zyrtec) or loratadine (Claritin, Allegra).
- Taking oral decongestants, such as pseudoephedrine or phenylephrine. However, these medications can affect blood pressure and should be avoided by anyone who has blood pressure problems.
- Temporarily using nasal decongestants to relieve nasal swelling. However, these should not be used on a regular basis because they can result in bleeding and ineffectiveness over time.
If your symptoms don’t respond to conservative treatments, a doctor may recommend surgery to reduce the size of the turbinates. There are three main surgical approaches to reducing turbinate hypertrophy:
- Inferior turbinate bone resection (ITBR). This involves removing a portion of bone of the inferior turbinates to promote airflow in the nose.
- Partial inferior turbinectomy (PIT). This procedure involves removing soft tissue of the inferior turbinate.
- Submucosal diathermy (SMD). This procedure involves using a special needle called a diathermy needle to use heat energy to shrink the soft tissue inside the turbinates.
Many different approaches to turbinate surgery exist. A doctor may make recommendations based on how severe your symptoms are. Turbinate surgery can be difficult because a doctor should not completely remove the turbinates since they serve an important purpose. If a doctor removed all of your turbinates, you might experience a dry, stuffy nose on a permanent basis. Doctors call this “empty nose syndrome.”
Untreated turbinate hypertrophy can cause symptoms to get worse. A person can develop severe difficulty breathing through their nose. This makes it hard to get restful sleep. A person may also experience frequent sinus infections, which can make it difficult to be productive in school or work.
Turbinate hypertrophy can be a temporarily annoying condition or a chronic one that impacts your quality of life. If over-the-counter treatments aren’t effective, many people report a significant reduction in symptoms with surgical treatments. Seeking treatment by an ear, nose, and throat specialist can help you learn how to start feeling and breathing better.