Generally speaking, it is healthier to breathe through the nose as it allows the body to better utilize the air during inhalation. However, many people find themselves breathing through their mouth more often for several reasons, like increased congestion or nasal obstruction. The nasal cavity is made up of many smaller parts that work simultaneously to facilitate air reaching the lungs through nasal breathing, but what happens when there is an obstruction that cannot be easily cleared?
What is an inferior turbinate?
Nasal turbinates, also known as nasal conchae, are narrow passages that help to humidify and warm air as it flows through the nose. The nose is constructed with three turbinates on each side - the superior, middle, and inferior turbinates. While many people have three turbinates per nostril, some can have four.
The inferior turbinate holds the primary responsibility for the direction of airflow as well as humidification, warming, and filtering out environmental toxins with each breath that is inhaled through the nose.
What is a large inferior turbinate?
The turbinates, or bony structures within the nose, are encased in soft tissue (mucosa) that helps to regulate the flow of air during inhalation. While the inferior turbinate is the most important turbinate in regards to humidifying and warming the air as it passes through the nasal cavity, it is also the most common culprit of nasal obstruction.
When the inferior turbinate becomes too large, whether it be from inflammation, allergens, or infection, the entire airway on the affected side becomes blocked, preventing airflow through the passage. The extreme swelling or enlargement of the inferior turbinate or the soft tissue surrounding it is known as inferior turbinate hypertrophy.
REquest An Appointment for evaluation for Large INferior Turbinate
Large Inferior Turbinate Symptoms
Symptoms associated with inferior turbinate hypertrophy often coincide with symptoms of a persistent cold that will not let up. The most obvious symptom of a large inferior turbinate is difficulty breathing nasally in one or both nostrils. Other symptoms include:
An altered sense of smell
Excessive dry mouth as you wake due to increased mouth breathing
Pressure on the forehead
Increased nasal drainage and runny nose
Epistaxis (nose bleeds)
Inferior turbinate hypertrophy symptoms are likely to be confused with symptoms linked to a deviated septum as both create obstructed airflow making breathing more difficult.
Causes of Large Inferior Turbinates
Swelling and enlargement of the turbinates may be a one-time thing or can become a chronic condition. The soft tissue surrounding the turbinate bone may become enlarged for many reasons such as:
Environmental allergens or irritants
Infections such as the common cold, upper respiratory infection, or sinus infection
Allergic or non-allergic rhinitis
Exposure to certain medications
A deviated septum
How to Get a Diagnosis of Large Inferior Turbinates
If you have been experiencing increased difficulty breathing through your nose with persistent cold symptoms that do not go away, it might be time for a trip to your primary doctor or ENT specialist if you have already established care with one.
To diagnose inferior turbinate hypertrophy, an Otolaryngologist will assess the symptoms you are experiencing, perform a visual examination of the nasal cavity, and request further testing as needed. If there is no obvious obstruction during a standard examination, your doctor will perform a scope procedure using a small fiber optic camera attached to a flexible tube to view the internal areas of the nasal cavity.
Depending on the time constraints of your doctor, a second appointment may be necessary to perform the scope test. This examination will provide an in-depth assessment of your symptoms.
Large Inferior Turbinate Treatment Options
As with any medical condition, treating inferior turbinate hypertrophy varies based on the severity of obstruction, whether the condition is acute or chronic, and the personal recommendations of your ENT doctor.
For many, the first step in treating large inferior turbinates is to try various at-home treatments to shrink the affected turbinates without invasive procedures. These options include:
Reduction of environmental allergens in the home
Do you live in a home filled with children and pets? Let’s face it, both require immense cleaning efforts to minimize dust, dander, and other environmental allergens. To cut down on these allergens in the home, doctors recommend:
Regularly vacuum carpets, drapes, furniture, and pillows to reduce the presence of dust, pet dander, and other irritants.
Gather toys in your home that are covered with fabric, place them in a ziplock freezer bag, and place them in the freezer for at least 24 hours to kill dust mites.
Place a dust-proof mattress cover on all mattresses in the home.
Do not smoke inside the home.
Remove all mold and mildew spots with cleaners formulated specifically to kill the mold.
Utilize HEPS filters in all rooms.
Use of Over-the-counter and prescription medications
Medications, whether bought over-the-counter from the drug store or provided via prescription from your doctor, can greatly reduce swelling and inflammation affecting the turbinates. These medications include:
Over-the-counter nasal sprays
Antihistamine nasal sprays
Steroid nasal sprays
It is important to note that nasal decongestants are not designed for long-term use and should not be used for more than three days. Prolonged use of these medications can worsen symptoms, increase swelling and inflammation, cause nose bleeds, and lead to addiction.
Alternatives to At-Home Treatment
When symptoms do not respond to at-home treatment options or your inferior turbinate hypertrophy is a chronic condition, your doctor may recommend surgical intervention to correct the problem.
Surgery to correct turbinate hypertrophy includes:
Inferior turbinate bone resection: This procedure involves removing a section of the inferior turbinate bone to promote airflow through the nose. Inferior turbinate bone resection is generally a safe procedure. If too much tissue is removed, it can alter the turbinates' ability to adequately humidify air, resulting in a permanently crusting, dry nose.
Partial inferior turbinectomy: A partial inferior turbinectomy involves removing soft tissue surrounding the inferior turbinate rather than the bone itself. Similar to bone resection, removing too much tissue can cause long-term problems and pain.
Submucosal diathermy: The submucosal diathermy procedure involves the use of a diathermy needle that utilizes heat energy to shrink soft tissue in and near the enlarged turbinates. Because the turbinates should not be completely removed as they have a crucial role in humidifying and warming the air as it travels through the nose, many surgeries can be difficult to completely correct the problem. These surgeries are also associated with the risk of swelling, bleeding, infection, dryness inside the nasal cavity, and growth of turbinate hypertrophy.
Vivaer nasal airway remodeling procedure: The Vivaer procedure is an in-office treatment option for various nasal airway disorders like inferior turbinate hypertrophy. This minimally invasive procedure does not require general anesthesia and is virtually pain-free for the patient. It is an excellent option for those suffering from nasal airway obstructions, nasal valve narrowing, and excess snoring.
Treatment for Inferior Turbinate Hypertrophy at Houston ENT and Allergy
Established in 1907, Houston Ear, Nose, Throat, and Allergy has been serving the greater Houston community for more than 100 years. Throughout the years, our team has seen many medical advances in diagnosing, treating, and preventing many medical disorders. Our specialists use the latest technology to provide ENT services, facial plastic surgery, treatment for hearing disorders, and allergy services.
With the ever-changing technology, our approach to treatment is continually changing to ensure the safest, least-invasive treatment options, like Vivaer nasal airway remodeling, are available to our patients.
The specialists at Houston Ear, Nose, Throat, and Allergy are board-certified physicians with a passion for diagnosing, treating, and providing education to prevent ENT conditions that may affect a person's daily life. If you are suffering from chronic congestion, hearing problems, or other allergy-related symptoms, schedule an appointment today.
Dr. Suchanova is a Diplomate of the American Board of Otolaryngology Head and Neck Surgery and a Fellow of the American Academy of Otolaryngology Head and Neck Surgery.
She is fluent in English, Czech, Slovak and conversational in Spanish.