Do You Need Surgery for Nasal Turbinate Hypertrophy and Deviated Septum?

Do turbinate hypertrophy and deviated septum require surgery?

I have been experiencing a persistent cough for about three months.
After visiting an otolaryngology clinic, the doctor diagnosed me with turbinate hypertrophy and a deviated septum, and suggested surgical treatment.
I have several questions:
1.
Is the condition severe enough to require surgery? If surgery is necessary, what are the potential side effects, complications, or aftereffects? What does the surgical procedure entail (e.g., will anesthesia or laser be used)? After the surgery, will it be a permanent solution, or is there a chance of recurrence?
2.
What causes turbinate hypertrophy and a deviated septum (e.g., bacterial or viral infections, or external trauma)?
3.
Regarding the above, should I control my diet or lifestyle habits?
4.
What does the term "vertigo syndrome and labyrinthine disorders" mean? Is it a disease name or a symptom? Does it require treatment?
5.
Currently, I have high blood pressure (150/100) and have been taking cardiovascular medication—Norvasc—for about four days.
Additionally, I have symptoms of gastroesophageal reflux.
Will these factors affect the aforementioned issues or the treatment process?
Thank you for taking the time to clarify these concerns for me.

Gu, 30~39 year old female. Ask Date: 2005/01/21

Dr. Cai Hongyan reply Otolaryngology

Hello,
1.
If the medication treatment is ineffective, surgical intervention is necessary to address the discomfort.
The potential complications include risks associated with anesthesia and bleeding.

Process:
1.
If using laser treatment, local anesthesia can be applied, which may be less effective but is safer.

2.
In traditional methods, excision of the inferior turbinate mucosa requires general anesthesia and does not provide a permanent solution; medication is still needed to prevent recurrence.

2.
Chronic inflammation due to nasal allergies can lead to turbinate hypertrophy, and the nasal septum remains congenitally shaped.

3.
Medications (such as nasal sprays) are required for management.

4.
The condition may cause dizziness, necessitating medication treatment.

5.
Blood pressure must be well-controlled prior to surgery, as high blood pressure during or after the procedure can lead to significant bleeding.
Gastroesophageal reflux disease (GERD) can also cause coughing; if this condition is present, it should be treated first, as the cough will not improve otherwise.

Reply Date: 2005/01/21

More Info

When considering surgery for nasal turbinate hypertrophy and a deviated septum, it's essential to understand the underlying conditions, potential benefits, risks, and the overall treatment process.

1. Is Surgery Necessary?
Surgery is often recommended for significant nasal obstruction caused by turbinate hypertrophy and a deviated septum, especially when conservative treatments (like nasal sprays or allergy medications) have failed. If your symptoms, such as chronic cough, nasal congestion, or difficulty breathing, are severely impacting your quality of life, surgical intervention may be warranted.
Surgical Options:
- Septoplasty: This procedure corrects the deviated septum, allowing for improved airflow.

- Turbinate Reduction: This can be done using various techniques, including radiofrequency ablation or laser surgery, to reduce the size of the turbinates.

2. Risks and Complications
As with any surgery, there are potential risks and complications:
- Bleeding: This is a common risk, but it can usually be managed effectively.

- Infection: Though rare, infections can occur post-surgery.

- Persistent Symptoms: Some patients may continue to experience nasal obstruction or other symptoms even after surgery.

- Empty Nose Syndrome: A rare condition where patients feel a sensation of nasal obstruction despite having clear nasal passages, leading to discomfort.

3. Surgical Process
The surgery is typically performed under local or general anesthesia, depending on the complexity of the case and the patient's comfort level. The procedure usually lasts about 30 to 90 minutes. Post-operative care is crucial, and patients are often advised to avoid strenuous activities for a few weeks.

4. Recurrence of Symptoms
While surgery can provide significant relief, it is not always a permanent solution. Factors such as allergies, environmental irritants, and anatomical variations can lead to recurrence of symptoms. Regular follow-ups with your ENT specialist are essential to monitor your condition.

5. Causes of Turbinate Hypertrophy and Deviated Septum
Turbinate hypertrophy can be caused by chronic inflammation due to allergies, irritants, or infections. A deviated septum may result from trauma or may be congenital. Understanding the cause can help in managing symptoms and preventing recurrence.

6. Lifestyle and Dietary Considerations
While there are no specific dietary restrictions related to turbinate hypertrophy or a deviated septum, maintaining a healthy lifestyle can improve overall respiratory health. This includes:
- Staying hydrated
- Avoiding known allergens
- Quitting smoking
- Managing allergies effectively

7. Understanding "Dizziness and Labyrinthine Disorders"
The term "dizziness and labyrinthine disorders" refers to conditions affecting the inner ear, which can lead to balance issues and vertigo. These symptoms can be related to nasal and sinus issues, particularly if there is significant congestion affecting the Eustachian tubes, which connect the middle ear to the back of the nose. Treatment may involve addressing the underlying nasal issues, and in some cases, vestibular rehabilitation may be recommended.

8. Impact of Current Medications
Your current medication for high blood pressure (Norvasc) and symptoms of gastroesophageal reflux (GERD) should be discussed with your ENT specialist and primary care physician. While these medications may not directly affect the surgical procedure, they can influence your overall health and recovery process. It's crucial to ensure that all your healthcare providers are aware of your complete medical history and current medications.

In conclusion, surgery for nasal turbinate hypertrophy and a deviated septum can significantly improve quality of life for those suffering from chronic nasal obstruction. However, it's essential to weigh the benefits against the risks and to engage in a thorough discussion with your ENT specialist to determine the best course of action tailored to your specific situation.

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