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Nasal Mucotomy of the Inferior Turbinates

What are nasal interior turbinates?

A nasal turbinate is a long, narrow, curled shelf of bone that protrudes into the breathing passage of the nose. The turbinates divide the nasal airway into 4 groove-like air passages, and are responsible for forcing inhaled air to flow in a steady, regular pattern around the largest possible surface area of nasal mucosa, which, as a ciliated mucous membrane with shallow blood supply, cleans and warms the inhaled air in preparation for the lungs.

The most common causes of nasal turbinate enlargement are long-term “conventional” nose drops / nasal spray, allergic rhinitis, chronic non-allergic rhinitis, medicine side effects, nasal congestion, reflux and pregnancy.

Nasal cavity - Medicover Hospital
Nasal cavity - Medicover Hospital

Why is mucotomy needed?

Nasal mucotomy is usually needed because of nasal obstruction which is a fairly common problem. Patients with nasal obstruction have trouble breathing through their nose. This can force them to breathe through their mouth, leading to a sensation of a dry mouth. In many patients, these symptoms get worse at night when they are lying flat. This can cause them to have less restful sleep.

How does the procedure work?

Nasal mucotomy of the inferior turbinates is a simple procedure done under local anesthesia for patients who failed treatment conservatively. A very common technique is to only remove a small amount, not enough to take away too much cilia. The procedure is easy to perform, there is no bleeding, and it is painless and done as a day case procedure. In certain cases, the position of the turbinates is such that the middle turbinate blocks sinus drainage. Here it is necessary to modify the turbinate to allow sinus drainage.

What are the benefits and risks of the surgery?

The benefit of the operation is the withdrawal of the symptoms and have less trouble with infections in the future.
As with any surgical procedure, nasal mucotomy has associated risks. Although the chance of a complication occurring is very small, it is important that you understand the potential complications such as dryness of the nasal and pharyngeal mucosa as well as scarring or secondary bleeding. Ask your surgeon about any concerns you may have.

Am I a good candidate for the surgery?

If alternative treatments have not been successful in improving your symptoms, surgery may be helpful. Your ENT (ear, nose and throat) surgeon will recommend nasal mucutomy if it is necessary based on your medical history and symptoms.

How should I prepare for the surgery?

Be aware of any restrictions specified before your appointment. You ENT surgeon will provide you with all the information regarding preparation for physical exams, diagnostic, blood and allergic tests.
Surgeons recommend that patients avoid any medications that may lead to bleeding, such as aspirin and ibuprofen products. If you have any questions about which medications you should or should not take, you must ask your surgeon.

What shall I do after mucotomy?

You can expect to have pain, fatigue, nasal stuffiness, and mild nasal drainage after your surgery. Pain is generally mild with this type of surgery and is typically well controlled with pain medications by mouth. The stuffiness typically results from swelling after the procedure, and typically starts to improve after the first week. You may have drainage of some mucus and blood from your nose after surgery. This is a normal part of the healing process.

Why is post-operative check-up important after the operation?

The first control after the nose removal surgery is due within a week when nasal cleansing treatment is needed to prevent the formation of adhesions and infections. The healing of the nose takes 3-10 weeks depending on the method of surgery.

You may be asked to use saline sprays or irrigations after your surgery. Please check with your surgeon about any post-operative care you will need to perform to allow your nose to heal properly.