Do I need surgery?
Hello Dr.
Yeh,
I previously underwent surgery to correct a deviated septum, and while the central airway has improved, I now experience persistent nasal congestion on the right side.
I am congested for about 80% of the day, and the blockage feels severe.
At home, I often have to lie on my side for a while to relieve the congestion, but it quickly returns.
When I'm not at home and unable to lie down, I can only breathe through one side.
I had a CT scan at the hospital, which clearly showed that the right nasal turbinate is significantly hypertrophied compared to the left, almost three times its size.
Although there are no structural abnormalities currently, I still experience nasal congestion.
I recall that after the surgery, the doctor mentioned being cautious about removing too much of the hypertrophied turbinate, and I wonder if this is the primary cause of my current congestion.
I consulted with other doctors at different hospitals, and they all said that no further intervention is necessary.
However, the congestion is affecting my daily life, leading to poor mood, decreased work efficiency, and strained interpersonal relationships.
I often feel frustrated and irritable due to this issue.
Therefore, I would like to ask for your advice, Dr.
Yeh.
Thank you for taking the time for this online consultation.
Attached is the image link: http://tw.myblog.yahoo.com/jw!G63u032RHRQg9_TeWw--/photo?pid=110
A-Hsien, 30~39 year old female. Ask Date: 2011/01/22
Dr. Ye Dawei reply Otolaryngology
Dear Sir/Madam,
Q: I have a deviated septum and after undergoing surgery at the hospital, the doctor mentioned that he was hesitant to remove too much of the hypertrophied inferior turbinate.
Could this be the main cause of my nasal congestion?
A: It is possible.
A: You may consider laser treatment.
Please come to my clinic for an examination.
Dr.
Yeh Da-Wei, Head of the Department of Otolaryngology, Hsinchu Hospital.
Reply Date: 2011/01/22
More Info
Persistent nasal congestion after septoplasty can be a frustrating and debilitating condition. It is understandable that you are seeking clarity on whether further surgical intervention is necessary given your ongoing symptoms.
From your description, it seems that you have undergone a septoplasty to correct a deviated septum, which is a common procedure aimed at improving airflow through the nasal passages. However, despite the surgery, you are experiencing significant nasal congestion, particularly on the right side, which appears to be associated with hypertrophy (enlargement) of the inferior turbinate on that side. This condition can indeed lead to persistent nasal obstruction, as the turbinates play a crucial role in regulating airflow and humidity in the nasal passages.
The fact that your CT scan shows a significant enlargement of the right inferior turbinate suggests that this could be a contributing factor to your symptoms. While the septoplasty may have corrected the structural alignment of the septum, it does not directly address issues related to the turbinates. In some cases, turbinate hypertrophy can be treated with medical management, such as nasal corticosteroids, which can help reduce inflammation and swelling. However, if these conservative measures do not provide relief, surgical options may be considered.
There are several surgical procedures that can be performed to reduce turbinate size, including turbinate reduction or submucosal resection. These procedures aim to alleviate nasal obstruction by decreasing the volume of the turbinates, thereby improving airflow. It is essential to have a thorough discussion with your ENT specialist regarding the potential benefits and risks of such procedures, especially considering your previous surgery and current symptoms.
Additionally, it is important to address the impact that your nasal congestion is having on your quality of life. Chronic nasal obstruction can lead to a range of issues, including sleep disturbances, decreased work performance, and emotional distress. If your symptoms are significantly affecting your daily life, it is reasonable to pursue further evaluation and treatment options.
In terms of communication with your healthcare provider, it may be helpful to prepare a list of questions and concerns before your appointment. This can ensure that you cover all relevant topics during your consultation. You might want to ask about the potential for turbinate reduction surgery, the expected outcomes, and any alternative treatments that may be available.
In conclusion, while surgery may not be the first-line treatment for every case of persistent nasal congestion after septoplasty, it can be a viable option if conservative measures fail to provide relief. Your ongoing symptoms, particularly the significant turbinate hypertrophy, warrant further evaluation and discussion with your ENT specialist to determine the best course of action for your situation.
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