When is this procedure indicated?
Turbinoplasty is indicated when the patient complains of respiratory obstruction attributable to hypertrophy of the nasal cornets (or turbinates). It can be performed as a stand-alone procedure, or in conjunction with septoplasty or FESS.
How is it performed?
Unless combined with other surgeries, turbiniplasty surgery is generally performed under local anesthesia.
Generally using rigid optics, the mucosa of the turbinates can be reduced by various techniques, such as using radiofrequency or bipolar forceps. In some cases, where there is particular prominence of the bone structure, the latter may be partially dislocated.
When the operation is performed under local anesthesia, the patient is generally discharged in a few hours. Perceived pain is usually completely negligible, and health care professionals instruct the performance of nasal washes and the use of nasal creams/sprays. The first post-operative checkup is generally scheduled after 7-10 days, at which time any crusting is removed and tissue healing is checked. The patient may experience a strong sense of cold for several days, associated with the presence of nasal secretions. You should avoid physical exertion, exposure to heat, smoking, use of medication that promotes bleeding (unless considered necessary), blowing your nose and sneezing with your mouth closed for about 3 weeks (it is useful as a substitute to do lots of nasal washes and sneezing with your mouth open), and follow any other instructions given by your health care providers.
Complications of the surgery are rare, and also depend on the patient's comorbidities; they will be explained in detail prior to surgery. The most common ones include:
- epistaxis, which should not be confused with the presence of secretions with minimal blood component. If this occurs during hospitalization, the health care providers should be notified; if the patient has already been discharged, it is generally indicated to compress the nasal pyramid, apply ice locally if possible and go immediately to the emergency room;
- surgical site infection, for which medical re-evaluation is required for proper medical or surgical management;
- formation of synechiae (scarring adhesions), reducing the space for respiratory flow.
The main problem after the intervention is the relapse: the intervention acts on the manifestation of a pathological process, not on the underlying cause (e.g. allergic rhinitis). It is therefore possible to develop turbinate hypertrophy again, but the timing is difficult to predict.