Coblation Turbinate Reduction (Turbinoplasty/Turbinectomy) for Nasal Congestion, Nasal Obstruction, & Rhinnitis

Coblation Turbinate Reduction for Nasal Congestion,
Nasal Obstruction, & Rhinnitis (www.TurbinateReduction.com)
by Fauquier ENT Consultants • Last Modified 2/21/2009 •

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Watch Video on Turbinate Reduction

Often, people present to their ENT complaining of nasal obstruction and nasal congestion. Sometimes, these symptoms are due to allergies and at other times, they may be due to anatomical factors such as a deviated septum, adenoid hypertrophy, or turbinate hypertrophy. Though most people understand that the septum (a wall that divides the nasal cavity into a right and left side) as well as large adenoids contribute to nasal obstruction, many don't realize that turbinates also play a significant role. Normally, turbinates are tissue masses extending into the nose from the sides which warm and humidify the air we breathe (arrow in picture). Click here to watch a short movie clip showing the inferior turbinate as a scope enters the nose.

However, in many patients, the inferior turbinates become so unusually large that they contribute to not only nasal obstruction, but also:

nasal congestion and/or obstruction
a persistent clear runny nose (vasomotor rhinnitis)
alternating nasal obstruction on the side one lays down on (right nasal obstruction when laying down on the right which than switches side when laying down on the left).

These symptoms are true for not only adults, but kids as well! Generally speaking, adenoids cause nasal obstruction in the back of the nose whereas turbinates cause nasal obstruction in the front aspect of the nose. The septum can cause obstruction anywhere in the nose.

The turbinates can fluctuate in size in the same individual so that nasal obstruction may vary throughout a given day and depending on the position of the head (laying down versus standing up). Here are some actual images taken of the inferior turbinates.


Normal Turbinate Appearance & Size	Moderate Turbinate Hypertrophy	Severe Turbinate Hypertrophy

Turbinate reduction (also known as turbinoplasty or turbinectomy) is a surgical procedure that reduces the overall size of the turbinates allowing for airflow which results in symptommatic relief of nasal obstruction and congestion. In people who suffer from persistent clear rhinnitis (runny nose) also known as vasomotor rhinnitis, there is an average reduction of nasal drainage by about 50%.

There are 2 main ways turbinate reduction is performed depending on exam and symptom complaints:

Method #1: Coblation Sub-Mucosal Turbinate Reduction (SMR) is by removing internal turbinate tissue as well as shrinking the turbinate by a method called submucosal coblation and can be done under local in an office setting (no IV is even needed). There is no packing, no pain, no downtime, no recovery period, and for most people, it is permanent. From start to finish, the procedure does not exceed 10 minutes. Often patients are able to resume all activites within 15 minutes after the procedure is completed. Keep in mind that there is NO pain during the procedure. Here's a movie from the patient's perspective. The pictures shown below were taken from this movie clip. Both kids as well as adults benefit from this procedure, though kids generally will require anesthesia as they usually can't stay absolutely still when having this procedure done.


Here the coblation device is inserted into the inferior turbinate.	Appearance prior to coblation turbinate reduction	Appearance immediately after coblation turbinate reduction performed. Overall size decreased by 50%.

Method #2: Extra-Mural Turbinate Reduction is by physically removing a portion of the turbinate. This method needs to be performed under anesthesia in the operating room and takes about 10 minutes to perform. It usually takes about 3 weeks before things heal to the point that patients start to notice a significant improvement. This method is only rarely recommended. At most, no more than 25% of the turbinates are removed.

Of note, we do NOT advocate complete or near-complete turbinate removal as it may lead to a devastating condition known as empty nose syndrome.

In order to determine which method is best for you, make an appointment in our office! Sub-mucosal turbinate reduction (Method #1) is performed every Friday afternoon in an office setting. There is no downtime and the patient is able to resume all normal activities within minutes after the procedure.

If you live far away, click here for more information.

To read more about how to correct a deviated septum, go here.

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