Nasal turbinate correction is a surgical procedure to treat altered turbinates that interfere with breathing.
The nasal cavity is divided by the septum nasi (nasal septum) and consists of the vestibule nasi (nasal vestibule) and the cavum nasi (nasal cavity). Laterally, the three conchae nasales (nasal conchae) arise: the concha inferior, the concha mediale, and the concha superior. The turbinates delimit the upper, middle and lower nasal passages. A number of causes lead to stenosis (narrowing) of these airways, and changes in the inferior concha are particularly common.
Indications (areas of application)
- Anatomical variants of the turbinates.
- Chronic nasal dysfunction with reflex compensatory hyperplasia of the tissue (excessive growth)
- Hyperreflective rhinitis or vasomotor rhinopathy – severe watery secretion of the nasal mucosa due to a dysfunction triggered by external or internal factors.
- Mucosal hyperplasia (excess of nasal mucosa).
- Nasal septum deviation (nasal septum curvature) with reflex compensatory hyperplasia of the tissue.
- Trauma – injury to the turbinates with reflex, compensatory hyperplasia of the tissue.
- Enlargement of the bony part of the turbinates.
- Soft tissue changes, which can be, for example, chronic, drug-induced or hormonal.
The surgical procedures
The goal of surgical procedures is to reduce the mussel tissue as gently as possible. A number of procedures can make this possible:
- Electrosurgical coagulation – In this method, surface anesthesia (numbing of the mucosa) is performed first, followed by decongestion of the nasal mucosa with a vasoconstrictor additive (substance that constricts blood vessels, causing decongestion). This procedure is necessary so that the surgeon can examine the turbinates without swelling. In stitch coagulation, a needle electrode is inserted into the turbinate body and the tissue is obliterated in a precisely circumscribed area by a short burst of electricity. The treatment may be repeated several times.
- Partial conchotomy – After decongestion, the nasal cavity is examined endoscopically for pathologic (abnormal) findings. The procedure can be performed under general anesthesia or with local anesthesia. The surgery involves removal of bone tissue from the os turbinale (bone of the inferior turbinate) and removal of excess mucosal flaps with conchotomy scissors (also called strip conchotomy). Care is taken to preserve healthy, functional tissue.
- Total conchotomy – Complete surgical removal of the inferior turbinate is rarely performed because it can result in pain and drying of the nasal cavity.
- Mucotomy – This surgery is very similar to conchotomy, but no bone tissue is removed.
- Submucosal resection of the os turbinale – In this procedure, after anesthesia and decongestion, the mucosa is mobilized and the bone tissue is removed with forceps. The wound is then closed with the mucosal flap (mucosal flap).
- Anterior turbinoplasty – This procedure is a modification of submucosal resection and differs in technique and performance.
- Lateroposition of the inferior turbinate – This procedure is used to permanently fix the turbinate in a lateral position to ensure airway patency.
- Cryoturbinectomy/Cryoconchectomy – Icing and subsequent removal of excess tissue at approximately -85°C.
- Laser turbinectomy – The excess tissue is vaporized with a carbon dioxide laser or an Nd-Yag laser.
