Definition and Overview
Turbinoplasty, also known as a turbinectomy, is a surgical procedure that involves the removal of turbinate bones in the nasal passage. It is often performed to relieve the symptoms and side effects of nasal obstruction.
The turbinate bone, also known as the nasal concha, is a shelf of bone that protrudes into the nose’s breathing passage. This long, narrow, and curved shape of the turbinate bone resembles an elongated seashell.
There are various conditions of the nose—including allergies—that can cause the turbinate bone to swell. When these bones are inflamed, the patient can experience nasal congestion and difficulty breathing.
It is important to note that turbinoplasty is not the first line of defence for patients experiencing nasal congestion or obstruction. It is only recommended when any other form of treatment—including medication and therapy—has failed to address the symptoms and allow the patient to breathe normally.
Who Should Undergo and Expected Results
Patients with the following conditions that have failed to respond to more conservative forms of treatment can elect to undergo this procedure:
- The turbinates are too bulky causing blockage in the nasal passages
- Severe allergies that cause the turbinate bones and tissues to swell and obstruct the nasal passages
- Deviated septum— This condition can be corrected by combining turbinoplasty and septoplasty
- Nasal congestion or obstruction that becomes worse when lying down
- Vasomotor rhinitis, or the persistent discharge of clear fluid from the nose
- Alternating nasal obstruction on the side where the patient lays down on
Correcting the turbinate bones through surgery can improve the patient’s breathing and minimise snoring at night.
How is the procedure performed?
A turbinoplasty is an outpatient procedure that can be performed under general or local anaesthesia with sedation in a hospital or surgical clinic. Prior to surgery, the patient is:
- Asked to stop taking certain medications such as naproxen (e.g. Naprosyn and Aleve), warfarin (e.g. Coumadin), ibuprofen (e.g. Motrin and Advil), and clopidogrel (e.g. Plavix), which can prevent efficient blood clotting during the procedure.
- Advised to consult with a paediatric anesthesiologist (for children patients) to ensure that there will be no adverse side effects from the anaesthetics during and after the procedure.
Turbinoplasty can be performed using any of the following techniques:
Outfracture approach - With this approach, the surgeon will insert a specialised tool into the patient’s nose to reposition the turbinate bones. Some of the tissues in the turbinates will be shaved off carefully to open up the nasal passages.
Coblation sub-mucosal turbinate reduction – This involves the removal of tissues surrounding the turbinate bones and the shrinking of the remaining structure through coblation (an advanced technology that uses gentle radio-frequency energy and natural saline). This method is often recommended for patients who want to achieve optimal results without severe pain, downtime, and extensive recovery period. The procedure often takes around 10 minutes and the patient can resume all normal activities right after.
Extra-mural turbinate reduction – This involves the opening of the nasal passages to surgically remove a portion of the turbinate. The procedure is typically performed under general anaesthesia and is followed by a three-week recovery period.
Possible Risks and Complications
Possible risks of a turbinoplasty include:
- Allergic reactions to medication and anaesthetics
- Formation of scar tissues or crusts inside the nose
- Formation of a hole in the tissue that divides the septum
- Fluid build-up in the nasal passages
- Change in the sense of smell
- Recurrence of nasal congestion or blockage after the surgery
- Loss of sensation in the skin of the nose
Ozcan KM, Gedikli Y, Ozcan I, Pasaoglu L, Dere H. Microdebrider for reduction of inferior turbinate: evaluation of effectiveness by computed tomography. J Otolaryngol Head Neck Surg. 2008 Aug. 37(4):463-8.
Tanna N, Im DD, Azhar H, Roostaeian J, Lesavoy MA, Bradley JP, et al. Inferior turbinoplasty during cosmetic rhinoplasty: techniques and trends. Ann Plast Surg. 2014 Jan. 72(1):5-8.