TURBINATES
AND TURBINATE REDUCTION
WHAT ARE
TURBINATES?
The
turbinates are scroll like structures located in the nasal cavity. The purpose of the turbinate is to humidify
and filter the air that is inhaled through the nose. The inferior
turbinate is a long structure and fills the lower portion of the nasal airway.
Its size will change dependent on numerous factors. It may become very swollen in response to
allergies, infections, or enlarged adenoids.
For example, when a cold causes severe congestion, it is usually the
inferior turbinate structure that swells.
TREATMENT OF ENLARGED NASAL TURBINATES
Enlarged
inferior turbinates are often the cause of chronic nasal congestion and nasal
obstruction. Primary medical treatment
usually consists of nasal steroids therapy.
Antihistamines, decongestants or antibiotics may also be used.
Even
after the underlying problem is addressed, such as adenoid removal, chronic
infection or allergy, the turbinate enlargement may remain. For patients who do not respond to medical
treatment, or those who find compliance with the medical therapy difficult,
surgical intervention may be beneficial.
SURGICAL OPTIONS FOR TURBINATE REDUCTION
There
are a variety of methods used to remove or shrink the nasal turbinate.
Coblation
Turbinate Reduction is the primary method used in our practice. This procedure will take place in the
operating room under general anesthesia.
The turbinate is shrunk down by placement of a surgical probe within the
inferior turbinate. The tissue is then coblated (a controlled, non-heat driven process using
radiofrequency energy) to vaporize the submucosal tissue. This allows the mucosal layer of the
turbinate to be preserved allowing for continued appropriate nasal
humidification and cleansing.
In most
cases, it is important that the turbinate not be removed completely because its
removal may result in a very dry, crusty nose that is unable to adequately
humidify and warm the air. Occasionally, turbinate tissue will re-grow after
turbinate surgery and the procedure may need to be repeated. This is preferable
to the situation of totally removing the turbinate.
ENLARGED TURBINATES- COBLATION TURBINATE - FOLLOWING TURBINECTOMY
REDUCTION
RISKS
As with any surgery, there are some associated
risks.
l Your child will receive general anesthesia for the procedure.
There is a small risk of complication due to the anesthesia.
l There is a very low risk of postoperative bleeding which would
require a trip back to the hospital for evaluation.
l Mild discomfort for generally 1-2 days.
l Most children are feeling back to themselves within one or two
days following the surgery. Some of the common complaints following the
surgery some mild nasal discomfort or sore throat. We will give you a
prescription for a pain medication that
should be taken as needed to help
relieve the discomfort.
SO MY CHILD NEEDS SURGERY, WHAT IS THE NEXT
STEP…
Choose
the date. You can pick the date you would like during your appointment
with us, or just give us a call. Please call the office where your child
was seen to schedule the surgery:
l
l
l North Haven- 203-234-8199
A
preoperative tour is available for you and your child if you are interested.
We strongly recommend taking advantage of this tour. During the
tour, your child will meet with a Child Life Specialist (if age appropriate)
who will help prepare your child for surgery using age appropriate play and
descriptions. You will also meet with a pediatric anesthesiologist
and pediatric nurse. To schedule an appointment, please call 203-688-7996.
All the
appropriate paper work will be completed during your visit with us, and in most
cases, there is no need for further preoperative physicals or paperwork prior
to the surgery.
THE DAY OF SURGERY….
The surgery is
preformed in the Pediatric Operating Room at Yale. The procedure will
take approximately 20-30 minutes. Following the operation, your child
will go to the pediatric recovery room (PACU or Post-Anesthesia Care
Unit). You can be with your child at this time. Some children are
disoriented and upset as they come out of the anesthesia. This is
normal. Your child will be ready to go home once they are drinking and
acting like themselves again. This normally takes an hour or
two.
WHAT
TO EXPECT FOLLOWING
SURGERY…
Your child will have
no limitations in diet following the surgery. They may eat or drink anything that they want… we find that children
who eat and drink well, stay hydrated and recover quicker.
If your child
is having postoperative pain, ensure that they are taking their pain
medicine.
There are no
limitations in activity. Most children will return to school and other
extracurricular activities within a day or two following the operation.
SITUATIONS THAT NEED MEDICAL ATTENTION
l If your child has any bleeding
(from the mouth or nose or vomiting blood), go to the emergency room.
l If your child has a fever greater
that 101.5 for more than 48 hours, please call us.
FOLLOW-UP
All the postoperative visits are scheduled with our nurse
practitioners, Wendy Mackey or Lisa Gagnon. We would like to see your
child three to six weeks following the surgery for a postoperative check.
Please call (203) 245-0496 to schedule an
appointment.
If you ever have questions or
concerns, we would be happy to talk to you or see your child at any time.
(203) 245-0496