Sleep Apnea Treatment
Partial Turbinectomy
Large, swollen inferior turbinates are frequently a cause of nasal blockage and potential cause of snoring and obstructive sleep apnea. If enlarged turbinates are caused by an allergy or environmental irritant, medical treatment of the underlying cause may reduce turbinate swelling and solve the problem. Long-term chronic swelling, associated with septal deviation however, can become irreversible and unresponsive to medical therapy. If so, you may need to have turbinate reduction surgery.Effective turbinate reduction surgery can be a challenge. The inferior turbinates need to be reduced enough in volume to relieve your nasal obstruction and restore healthy breathing and sinus drainage. Yet it's important not to remove too much of the turbinates, especially the mucous lining on the surface of the turbinates, because they serve such a critical function in the breathing process.
The turbinates are vital to normal breathing because they filter and humidify the air you breathe, as well as create the sensation of air flow through your nose. Your brain needs the special air flow receptor cells on the surface of the inferior turbinates to recognize air is passing through your nose.
If the receptors are removed, your brain would perceive that your nasal passages were blocked, even if they physically weren't (a condition called empty nose syndrome). This will also effect the normal laminar air flow through the the air passage.
The surface lining of the turbinates is also necessary because it secretes mucus that keeps the nose moist and limits dryness/crusting after surgery. Additionally, this lining contains thousands of cilia, tiny hairs that sweep the mucus through your nose and sinuses, trapping and evacuating dirt and bacteria.
Because of empty nose syndrome, the laminar air flow and the importance of mucus production and cilia, there has been a strong trend toward selective/partial turbinate reduction and away from extensive turbinate removal.
Surgery to reduce the turbinates size and restore laminar air flow has been preformed in patients with a verity of breathing disorders. The goals in turbinate surgery are to:
- Correct the nasal obstruction to restore laminar air flow and drainage
- Preserve the normal function of the mucous lining
- Minimize side effects, such as bleeding, crusting and pain
- Aid in the treatment of snoring and obstructive sleep apnea
- Assist Obstructive sleep apnea patient to wear Nasal CPAP
Modern techniques in turbinate reduction are to shrink the inflamed swollen turbinates and to out fracture the turbinate bone to increase the surface area for laminar air flow. There are multiple techniques utilized by our team and it is tailored for each patient.
- Partial turbinectomy/turbinoplasty
- Laser assisted partial turbinoectomy/turbinoplasty
- Radiorequency assisted turbinate reduction
Potential complications of turbinate surgery include:
- Bleeding
- Crusting (an excessively dry nose)
- Pain
- Atrophic rhinitis (chronic inflammation and thinning of the nasal mucous lining, often associated with dryness/crusting and foul discharge)
- Malodor (bad smell)
- Ozena (a condition of crusting in the nose, foul odor, and tissue atrophy)
- Anosmia (loss of sense of smell)