Deviated Septum and Enlarged Turbinate: Treatment Options - Otolaryngology

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Deviated septum and enlarged turbinates are common conditions that can significantly impact nasal breathing and overall quality of life. A deviated septum occurs when the thin wall between your nasal passages (the septum) is displaced to one side, which can lead to nasal obstruction. Enlarged turbinates, on the other hand, are structures within the nasal cavity that can become swollen due to various factors, including allergies, infections, or irritants. Together, these conditions can contribute to chronic nasal congestion, snoring, and sleep disturbances.

In your case, it sounds like you have already undergone a septoplasty (surgery to correct a deviated septum) but are still experiencing significant nasal obstruction and related symptoms. This is not uncommon, as some patients may have residual issues post-surgery or may develop new problems, such as turbinate hypertrophy, which can further obstruct airflow.


Treatment Options
1. Medical Management: Before considering further surgical options, it's essential to explore medical treatments. This may include:
- Nasal corticosteroids: These can help reduce inflammation in the nasal passages and may alleviate symptoms associated with enlarged turbinates.

- Antihistamines: If allergies are contributing to your symptoms, antihistamines can help manage allergic rhinitis.

- Saline nasal sprays: These can help keep the nasal passages moist and reduce congestion.

2. Surgical Options: If medical management does not provide sufficient relief, surgical options may be considered:
- Turbinoplasty: This procedure reduces the size of the turbinates to improve airflow. It can be performed in conjunction with septoplasty or as a standalone procedure.

- Septoplasty Revision: If the septum has not healed correctly or remains deviated, a revision septoplasty may be necessary.

- Radiofrequency ablation: This minimally invasive procedure can shrink the turbinates using heat, which may provide relief with less recovery time compared to traditional surgery.

3. Sleep Apnea Treatment: If snoring and sleep disturbances are significant, it may be worth evaluating for obstructive sleep apnea (OSA). Treatments for OSA can include:
- Continuous Positive Airway Pressure (CPAP): A CPAP machine helps keep the airway open during sleep.

- Oral appliances: These devices can reposition the jaw and tongue to keep the airway open.


Recommendations for Specialists
When seeking a specialist for your condition, look for an otolaryngologist (ENT) with experience in nasal surgeries. You can ask for recommendations from your primary care physician or check online reviews and ratings for local ENT specialists. Major hospitals or academic medical centers often have specialists who are well-versed in complex nasal surgeries.


Cost Considerations
The cost of surgery can vary widely based on your location, the specific procedures performed, and whether you have insurance coverage. In the U.S., the average cost for a septoplasty can range from $3,000 to $10,000, while turbinate reduction may add additional costs. After insurance, your out-of-pocket expenses will depend on your specific plan, including deductibles and co-pays. It’s advisable to contact your insurance provider for detailed information regarding coverage and costs.


Conclusion
In summary, if you continue to experience nasal obstruction and related symptoms after your previous surgery, it may be beneficial to consult with an ENT specialist who can evaluate your current condition and recommend appropriate treatment options. Whether through medical management or surgical intervention, addressing both the deviated septum and enlarged turbinates can significantly improve your quality of life and sleep.