Turbinoplasty
Solving permanently (chronic) blocked nose problems through radiofrequency turbinoplasty
Nasal congestion or inability to breathe are well known to most patients as being signs of an acute upper respiratory tract infection or an allergic reaction to the environment. However, in many patients, this obstruction becomes chronic and significantly affects their quality of life and sleep.
Stuffy nose is often due to an enlargement of the inferior turbinates. These are small structures composed of a sliver of thin bone covered with mucosa. They project into the nasal airways and help to warm, humidify and clean the inhaled air before it reaches the lungs. When the mucous membrane become inflamed (rhinitis), the blood vessels inside the turbinate bones swell up and dilate, causing the enlargement of the turbinates and nasal obstruction that is a reduction of airflow through the nose. Chronic stuffy nose can damage the normal breathing, forcing patients to breathe through their mouth and often affecting their daily activities.
The enlarged turbinates and the nasal congestion can also cause headaches and sleep disorders such as snoring and Obstructive Sleep Apnoea Syndrome (OSA). Chronic stuffy nose is often insensitive, in the long or short term, to a medical treatment such as nasal sprays.
Surgical treatment is indicated only when patients do not respond to medical treatments. Turbinoplasty, which aims to reduce the size of the turbinates, can be performed under local anaesthesia or in the operating room under general anaesthesia.
Superficial cauterisation (burns) of enlarged turbinates can be performed with an electrosurgical probe or a laser either on the surface of the turbinate tissue or submucosa. It produces invariably an oedema, scabs, and nose bleeds during the recovery period that can last three weeks or more.
Another method to solve nasal obstruction is the outward fracture of the turbinate bone(s), which moves the turbinate from its obstructive position into the airway. This approach, however, does not attack the root of the obstruction. The fractured turbinate often returns to its previous position and the submucosa tissue remains enlarged.
Turbinectomy consists of resection (removal of bone and/or soft tissue) or excision (removal of soft tissue only) of one or both inferior turbinates. The postoperative risks are haemorrhage and the empty nose syndrome, which is a paradoxical sensation of nasal obstruction, even though the nasal cavities are clear. The resections must be as parsimonious as possible.
Resection, excision and superficial cauterisation can all be associated with scabs and long healing, which can last for several weeks.
Nonsurgical solution for nasal congestions: radiofrequency turbinoplasty
Reducing turbinates through radio frequencies is a fast and effective way to relieve chronic nasal obstruction without pain or inconveniences associated with traditional techniques. Radiofrequency treatment is performed in the consulting room under local anaesthesia. The procedure usually takes less than two minutes per turbinate with no bandage needed. Postoperative pain is usually mild.
Radiofrequency is a new generation nonsurgical technique that uses a tiny electrode to heat turbinate tissue from the inside, reducing the size of the turbinate when the body reabsorbs the treated tissue. Since no tissue section is performed, there is a little or no bleeding, scab, or pain. The use of radiofrequency is not new in medicine. It has been used for decades in neurology, cardiology, urology and surgery. Radiofrequency is minimally invasive and can be performed under local anaesthesia and the patient can resume normal activity almost immediately. This method also preserves the normal function of the turbinate bone and gives the patient excellent airflow.
Before using this technique, a thorough evaluation and examination should always be conducted by an ENT head and neck surgeon. He will confirm the suspected diagnosis, as well as the relevance of this therapeutic choice.
Coverage of turbinoplasty by social security
This surgery is covered by social security, but your ENT head and neck surgeon may request an additional fee.
Dr. Stéphane Hervé is an ENT specialist and head and neck surgeon who graduated from some of the best universities in France. He has over 20 years of experience and a solid training in the surgical treatment of nasal congestion. He currently uses the new radio frequency technology with the Ellman Surgitron® 4.0 generator, which optimizes the control and precision of the surgical procedure and reduces nasal obstruction and posterior flows, while improving postoperative comfort.
