Treatment of Enlarged Inferior Turbinates
Chronic inferior turbinate hypertrophy is a common cause of nasal obstruction that can have significant effects on quality of life.1-3 Turbinate reduction, such as powered inferior turbinoplasty, may be necessary.
Inferior Turbinate Reduction: The Challenge
Anatomy and blood flow of the inferior turbinate
Nasal obstruction often results from inferior turbinate hypertrophy and contributes to rhinosinusitis and obstructive sleep apnea (OSA).
Medical therapy may be effective if an allergy or irritant causes the enlarged inferior turbinates. However, some patients may need inferior turbinate reduction, such as powered inferior turbinoplasty.
Turbinate Reduction Techniques
The challenge of inferior turbinate surgery is to achieve adequate turbinate reduction while preserving the ciliated epithelium as an important part of respiratory filtering.
Powered Inferior Turbinoplasty: Better Long-Term Results4-6
Surgical video of powered inferior turbinoplasty with our Inferior Turbinate Blade.
Inferior Turbinate Blade creating a submucosal pocket, not a subperiosteal pocket
Powered inferior turbinoplasty with our Inferior Turbinate Blade and Straightshot® M4 Microdebrider offers significant, long-term results with one treatment.4-6
- In two 3-year studies, patients who had a powered inferior turbinoplasty with the Inferior Turbinate Blade maintained an 82% average drop in severity of symptoms4-5
- An additional three-month study in children also showed an average 84% reduction in symptom severity6
The Inferior Turbinate Blade's patented elevator tip facilitates insertion into the inferior turbinate and the creation of a submucosal pocket for bulk reduction. This helps protect nasal mucosa and prevent the damage that can be caused by radiofrequency (RF) devices. Side effects with the microdebrider are similar to those reported with thermal turbinate reduction techniques such as RF.4-6
Thermal Techniques for Turbinate Reduction
Thermal techniques for turbinate reduction, such as laser and radiofrequency (RF), have gained popularity in recent years. Yet research indicates that one treatment does not offer long-term relief of nasal obstruction4-6 and these techniques can damage nasal mucosa.
Functional mucosa with ciliated epithelium is an important component of good nasal health. Studies demonstrate the potential effects of thermal turbinate reduction techniques on nasal mucosa. Berger et al7 showed:
- Significant fibrosis, glandular and sinusoid depletion, and partial epithelial shedding of the cilia
Salzano et al8 reported:
- Submucosal damage and necrosis
- Too much heat can damage the inferior turbinate and cause it to become chronically inflamed
Additional Products Related to Turbinate Reduction
Bioresorbable Nasal Packing
To absorb drainage, control minimal bleeding, and prevent the middle turbinate from lateralizing following functional endoscopic sinus surgery (FESS), Medtronic offers innovative bioresorbable nasal packing. It eliminates the need for packing removal, which can be extremely painful for your patients. Our bioresorbable nasal packing products use hyaluronic acid to help keep the surgical site moist, reduce adhesions, and decrease healing time after sinus surgery.9
- Nathan RA. The burden of allergic rhinitis. Presented at the Mid-Conference Symposium of the Eastern Allergy Conference; Naples, Florida. May 2006.
- Becker D. Sinusitis. J Long Term Eff Med Implants. 2003; 13(3):175-194.
- Bachert C, Van Bruaene N, Toskala E, et al. Important research questions in allergy and related diseases: chronic rhinosinusitis and nasal polyposis--a GALEN study. Allergy. 2009; 64:520-533.
- Liu C-M, Tan C-D, Lee F-P, Lin K-N, Huang H-M. Microdebrider-assisted versus radiofrequency-assisted inferior turbinoplasty. Laryngoscope. 2009; 119:414-418.
- Chen Y-L, Tan C-T, Huang H-M. Long-term efficacy of microdebrider-assisted inferior turbinoplasty with lateralization for hypertrophic inferior turbinates in patients with perennial allergic rhinitis. Laryngoscope. 2008; 118:1270-1274.
- Chen Y-L, Liu C-M, Huang H-M. Comparison of microdebrider-assisted inferior turbinoplasty and submucosal resection for children with hypertrophic inferior turbinates. Intl J Ped Otorhinolaryn. 2007; 71:921-927.
- Berger G, Ophir D, Pitaro K, Landsberg R. Histopathological changes after Coblation® inferior turbinate reduction. Arch Otolaryngol Head Neck Surg. 2008; 134(8):819-823.
- Salzano FA, Mora R, Dellepiane M, Zannis I, Salzano G, Moran E, Salami A. Radiofrequency, high-frequency, and electrocautery treatments vs partial inferior turbinotomy. Arch Otolaryngol Head Neck Surg. 2009; 135(8):752-758.
- Berlucchi M, Castelnuovo P, Vincenzi A, Morra B, Pasquini E. Endoscopic outcomes of resorbable nasal packing after functional endoscopic sinus surgery: a multicenter prospective randomized controlled study. Eur Arch Otorhinolaryngol. 2009; 266(6):839-845.