Turbinate Reduction: What to Expect

Did you know that your nose is made with built-in air filters? Inside your nose are three pairs of fleshy structures that help filter, warm, and add moisture to the air you breathe in. These structures are called turbinates.

Healthy turbinates will do a good job of regulating the temperature and level of moisture inside your nose. But if they become swollen, enlarged, or displaced, they can cause a nasal blockage. This can make it difficult to breathe.

The inferior turbinates are the ones near the nostril that you can see looking in your nose. These are the ones that are addressed in a turbinate reduction.

Some common and reversible causes of turbinate enlargement include:

• allergies
• infections
• weather changes
• stress
• medications
• hormonal changes

But there are some causes of turbinate enlargement or displacement that can’t easily be reversed and may require turbinate reduction. These include:

• chronic infections
• severe allergies
• anatomic issues with the nose

Turbinate reduction is also commonly recommended for those who undergo septoplasty, which is surgery to correct a deviated septum.

A deviated septum is a shift of the bone and cartilage between the nose’s two nostrils. It can cause compression of the turbinates and trouble breathing.

A turbinate reduction can help further open up the airways of a person who’s having a septoplasty.

There are several ways to reduce the size of the turbinates. Some are less invasive than others.

Cauterization, coblation, and radiofrequency reduction

In some cases, doctors recommend surgeries that shrink the turbinates without removing any underlying bone or tissue.

To do this, a surgeon uses a special needle-like device that heats the turbinates using a heat source or energy waves. This causes scar tissue to form, reducing the turbinates’ size.

These procedures fall under the categories of cauterization, coblation, and radiofrequency reduction.

They usually take about 10 minutes and can be performed under local anesthesia in a surgeon’s office. Local anesthesia is injected into the nasal tissues using a needle.

Usually no special preparation is needed. These procedures are often used in less severe cases of turbinate enlargement.

Surgical removal

In other cases, a doctor may recommend that parts of the turbinates be surgically removed. These procedures are usually done in an operating room under general anesthesia using a gas that you inhale or with an anesthetic given intravenously (through an IV).

You shouldn’t eat or drink beforehand, usually starting the night before. You should also avoid taking medications containing aspirin or ibuprofen for two weeks before surgery to minimize the risk of bleeding.

During this kind of turbinate reduction, a surgeon cuts into the turbinates to remove some of the bone beneath them, to reduce their overall size.

They may also use a small handheld device that can shave away some of the soft tissue of the turbinates, further opening your nasal cavity.

Surgical removal of underlying bone or tissue surrounding the turbinates is usually reserved for more serious cases of turbinate enlargement. It’s often done during a septoplasty.

A septoplasty also involves cutting into the lining covering the septum. A procedure called “outfracturing” involves breaking the bony part of the turbinates in order to reposition them more correctly.

Recovery times vary for each type of turbinate reduction procedure. For less invasive turbinate reductions, recovery is usually quick and not very painful. In about three weeks, the new scar tissue in your nose should be completely healed.

For the more invasive type of turbinate reduction surgery, recovery takes three to six months. Absorbable packing may be placed at the time of surgery, but not always. Over time, your nasal tissues will heal into place.

To avoid possible bleeding and swelling, avoid strenuous activities and blowing your nose for several weeks after your surgery.

Your doctor may also recommend you elevate your head while sleeping to avoid irritating your nose.

Side effects are less likely and less severe for less invasive turbinate reduction procedures. For about three weeks, you may experience crusting or nose dryness.

Using nasal saline irrigation and antibiotic ointment during this time can help control these side effects.

Side effects for more invasive turbinate reduction procedures involving removal of bone or tissue are more likely and can be more severe. Possible side effects include:

• pain
• bleeding
• swelling
• irritation
• dryness of the nasal cavities
• infection

There’s also a possibility that turbinate tissue may regrow after surgery, making it necessary to undergo further turbinate reduction treatment.

Less invasive turbinate reduction procedures may cost up to about $2,000 without health insurance. With insurance, it may cost half that or less, or could be free, depending on your health plan.

More invasive turbinate reduction procedures that involve bone or tissue removal in addition to a septoplasty may cost between $800 and $10,000 without insurance.

The cost of this surgery largely depends on the technique used and how long the removal procedure takes. With insurance, the cost may be as little as several hundred dollars, or even free, depending on your health plan.

The goal of turbinate reduction surgery is to shrink the size of the turbinates without removing too much tissue.

A lack of turbinate tissue may cause the nasal cavity to become very dry and crusty. In some cases, a reduced turbinate may regrow, requiring a repeat surgery to reduce their size.

In most cases, turbinate reductions are successful at opening the airways and making breathing easier. By following your surgeon’s pre-operative and after-care instructions, you can speed your healing and maximize your results.