Nasal Congestion: Diagnosing and Treating Middle Turbinate Hypertrophy

Q: Nasal Congestion: Diagnosing and Treating Middle Turbinate Hypertrophy

Mr. <br>Lin： Long-term nasal congestion is generally caused by a deviated septum and hypertrophy of the inferior turbinates. <br>The middle turbinate is usually small in size and is not easily observed; it rarely causes nasal congestion due to hypertrophy, but it can potentially

Nose

I have been experiencing nasal congestion 24 hours a day, and it has been getting worse over the past few years.
I visited an ENT specialist who diagnosed me with inferior turbinate hypertrophy.
The doctor administered a nasal spray, but it hasn't helped.
I informed the doctor that I still feel congested, and after another spray, the congestion persists.
I understand that the nose is divided into superior, middle, and inferior turbinates, and I suspect that my issue may be related to the middle turbinate.
I would like to ask how to determine if the middle turbinate is hypertrophied.
Is it visible to the naked eye, or does it require a nasal endoscopy for examination? Currently, medications and nasal sprays are ineffective, and I am unsure how to communicate this to my doctor, as they only mentioned the inferior turbinate and did not address the middle turbinate.
If the middle turbinate is swollen, would surgical treatment be necessary?

Lin, 20~29 year old female. Ask Date: 2001/03/13

Dr. Chen Junliang reply Otolaryngology

Mr.
Lin: Long-term nasal congestion is generally caused by a deviated septum and hypertrophy of the inferior turbinates.
The middle turbinate is usually small in size and is not easily observed; it rarely causes nasal congestion due to hypertrophy, but it can potentially lead to sinusitis.
If medications or nasal sprays do not provide relief, surgical intervention may be necessary.
This would involve performing a septoplasty and turbinate reduction through the nostrils, where the obstructive portion of the inferior turbinate is trimmed or removed.
The procedure typically requires a hospital stay of about three days, and improvement can be expected immediately after surgery.

Reply Date: 2001/03/13

More Info

Nasal congestion can be a frustrating and persistent issue, particularly when it affects your quality of life. In your case, it seems that you have been experiencing chronic nasal congestion, which has been worsening over the years. You mentioned that your ENT doctor diagnosed you with inferior turbinate hypertrophy and provided nasal sprays, but these have not alleviated your symptoms. You are also concerned about the possibility of middle turbinate hypertrophy and how it can be diagnosed and treated.

To begin with, it is essential to understand the anatomy of the nasal cavity. The nasal cavity is divided into three sections: the superior, middle, and inferior turbinates. These structures are responsible for filtering, humidifying, and regulating airflow through the nasal passages. When any of these turbinates become hypertrophied (enlarged), it can lead to nasal obstruction and congestion.

In your case, it is possible that the middle turbinate is contributing to your nasal congestion. While your doctor may have visually assessed the inferior turbinates, the middle turbinate may require a more detailed examination. Typically, an ENT specialist will use a nasal endoscope or a nasal speculum to get a better view of the nasal passages, including the middle turbinate. This examination allows the doctor to determine if there is any swelling or abnormality in the middle turbinate that could be causing your symptoms.

If the middle turbinate is indeed hypertrophied, treatment options may vary based on the severity of the condition and the impact on your quality of life. In some cases, conservative measures such as nasal corticosteroids or saline nasal sprays may be recommended to reduce inflammation and swelling. However, if these treatments are ineffective, surgical intervention may be necessary.
Surgical options can include procedures such as turbinate reduction, where excess tissue from the turbinates is removed to improve airflow. This can be done using various techniques, including radiofrequency ablation or submucosal resection. The goal of these procedures is to alleviate nasal obstruction and improve breathing.

It is crucial to communicate your symptoms clearly to your ENT doctor. You should express your concerns about the middle turbinate and how it might be contributing to your ongoing nasal congestion. If you feel that your current treatment plan is not effective, do not hesitate to ask for further evaluation or a referral to a specialist who can provide additional insights or treatment options.

In summary, diagnosing and treating middle turbinate hypertrophy involves a thorough examination by an ENT specialist, potentially using nasal endoscopy. If conservative treatments fail, surgical options may be considered to alleviate your symptoms. Open communication with your healthcare provider is key to finding an effective solution for your nasal congestion.

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