Enlarged turbinates
Turbinates are bony structures inside the nose, covered by soft tissue (mucosa). Located inside the nasal passageways on both sides near the septum, turbinates warm, humidify, and filter the air as it passes in route to your lungs. They do this by swelling up with increased blood flow.
There are three turbinates in each nostril (inferior, middle, and superior), and ideally there is space between the septum and turbinates to allow air to pass through the nose.
WHAT IS TURBINATE HYPERTROPHY?
If the turbinates become swollen or too large, it can cause breathing problems, which is referred to as turbinate hypertrophy.
Enlarged turbinates can be congenital, result from overgrowth of the bone, or occur as the result of chronic inflammation of the mucosal membranes that cover the turbinates.
For most patients, the soft tissue part of the inferior (lower) turbinates is the major problem.
DIAGNOSIS
A diagnosis can typically be obtained easily via nasal endoscopy. The endoscope will help to visualize the nasal and sinus passages and will help to determine the potential source of your nasal congestion. For some patients, CT scans and allergy testing may also be ordered
CAUSES & SYMPTOMS
Turbinate hypertrophy is typically caused when the lining of the skin covering the turbinate bone becomes enlarged and swollen. This can be an acute (one time) or chronic (ongoing) problem, and can be caused by many conditions including:
- Upper respiratory infection (common cold)
- Acute sinus infection
- Allergic rhinitis
- Non-allergic rhinitis
- Chronic rhinosinusitis
- Medications
- Hormonal changes
- Environment irritants (such as cigarette or cigar smoke)
- Aging
Symptoms of turbinate hypertrophy may include:
- Persistent nasal congestion
- Nasal obstruction
- Difficulty breathing through the nose
- Snoring
- Nosebleeds
- Mouth breathing during sleep
These symptoms are very similar to those of a cold. However, these symptoms won’t go away without treatment, which isn’t the case with a cold. The symptoms of turbinate hypertrophy can also be mistaken for those of a deviated septum, which is another condition that can block airflow through one or both nostrils.
Sometimes it is not clear why turbinates swell. In most cases, the swelling does not cause pain. But it can feel like an object is blocking one side of your nose.
TREATMENT
Treatment for chronically enlarged turbinates is developed on a case-by-case basis. Some patients may be able to manage this problem with proper medications such as nasal antihistamine sprays or nasal corticosteroid sprays.
However, when enlarged turbinates are unresponsive to medications and causing nasal obstruction and difficulty breathing through the nose, a surgical procedure may be a more appropriate treatment to remove them and /or reduce their size.