Middle Turbinate Hypertrophy: Treatment Options Explained - Otolaryngology

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Middle turbinate issues?


Hello, doctor...
Recently, I've been feeling unwell due to a cold, and I experienced some headaches, so I visited an ENT specialist.
The endoscopy revealed hypertrophy of the inferior turbinate, and there is also hypertrophy of the middle turbinate, showing signs of Middle Turbinate Syndrome.
There are many surgical options for the inferior turbinate, but for the middle turbinate, is the only option to excise it with a scalpel? Are there any minimally invasive procedures available, such as radiofrequency or laser surgery? Thanks.

Niming, 40~49 year old female. Ask Date: 2015/04/26

Dr. Zheng Jueyi reply Otolaryngology


Hello: Hypertrophy of the inferior turbinate does not necessarily indicate turbinate syndrome.
It is advisable to try medication first to see if there is any improvement.
If there is no improvement, further discussion with your physician about the possibility of surgery may be warranted.
Currently, turbinate surgery is often performed using endoscopic sinus surgery combined with powered instrumentation.
Additionally, options such as radiofrequency ablation or laser treatment can be discussed with your physician to determine if satisfactory results can be achieved.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/04/26

More Info


Middle turbinate hypertrophy is a condition where the middle nasal turbinates, which are structures inside the nose that help humidify and filter the air we breathe, become enlarged. This can lead to various symptoms, including nasal obstruction, difficulty breathing through the nose, and even headaches, as you have experienced. The condition can be associated with other issues such as sinusitis or allergic rhinitis, and it is often evaluated during an ENT (ear, nose, and throat) examination, as you have done.

When it comes to treatment options for middle turbinate hypertrophy, there are several approaches, ranging from medical management to surgical interventions.
1. Medical Management: Initially, treatment often starts with conservative measures. This can include the use of nasal corticosteroids, which help reduce inflammation and swelling of the nasal tissues. Antihistamines may also be prescribed if allergies are a contributing factor. Saline nasal sprays or rinses can help keep the nasal passages moist and clear of irritants.

2. Surgical Options: If medical management does not provide sufficient relief, surgical options may be considered. Traditionally, surgical intervention for hypertrophy of the middle turbinate has involved techniques such as submucosal resection or partial turbinectomy, where a portion of the turbinate is removed to alleviate obstruction.

- Radiofrequency Ablation: This is a minimally invasive technique that uses radiofrequency energy to shrink the tissue of the turbinate. It is performed under local anesthesia and typically has a shorter recovery time compared to traditional surgery. This method can effectively reduce the size of the turbinate and improve airflow through the nasal passages.

- Laser Surgery: Similar to radiofrequency ablation, laser surgery can also be used to reduce turbinate size. The laser energy targets the tissue, causing it to shrink. This method is also minimally invasive and can be performed in an outpatient setting.

- Coblation: This technique uses a combination of radiofrequency energy and saline to remove tissue at lower temperatures, which minimizes damage to surrounding structures. It is another option for turbinate reduction that is considered less invasive.

3. Endoscopic Techniques: Endoscopic approaches allow for direct visualization of the nasal passages and can be used to perform turbinate reduction with precision. These techniques can be combined with other sinus surgeries if necessary.

In your case, since you mentioned the presence of middle turbinate hypertrophy along with other symptoms, it would be beneficial to discuss these options with your ENT specialist. They can provide guidance on the most appropriate treatment based on the severity of your symptoms, the degree of turbinate enlargement, and any underlying conditions that may be contributing to your nasal obstruction.

It's important to note that while surgical options can provide significant relief, they are typically considered when conservative treatments fail. Additionally, the choice between traditional surgery and minimally invasive techniques like radiofrequency ablation or laser surgery will depend on various factors, including your overall health, the specific anatomy of your nasal passages, and your preferences regarding recovery time and potential risks.

In conclusion, middle turbinate hypertrophy can significantly impact quality of life, and there are multiple treatment options available. Engaging in a thorough discussion with your ENT specialist will help you make an informed decision about the best course of action for your specific situation.

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