A turbinectomy or turbinoplasty (preserving the mucosal layer) is a

surgical procedure Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...

, that removes tissue, and sometimes

bone A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...

, of the

turbinate In anatomy, a nasal concha (; : conchae; ; Latin for 'shell'), also called a nasal turbinate or turbinal, is a long, narrow, curled shelf of bone that protrudes into the breathing passage of the nose in humans and various other animals. The con ...

s in the

nasal passage The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nasal c ...

, particularly the

inferior nasal concha The inferior nasal concha (inferior turbinated bone or inferior turbinal/turbinate) is one of the three paired nasal conchae in the human nose, nose. It extends horizontally along the lateral wall of the nasal cavity and consists of a wikt:lam ...

. The procedure is usually performed to relieve

nasal obstruction Nasal congestion is the partial or complete blockage of nasal passages, leading to impaired nasal breathing, usually due to membranes lining the nose becoming swollen from inflammation of blood vessels. Background In about 85% of cases, nasal ...

s.Ye T, Zhou B. Update on surgical management of adult inferior turbinate hypertrophy. Curr Opin Otolaryngol Head Neck Surg. 2015 Feb;23(1):29-33. In most cases, turbinate

hypertrophy Hypertrophy is the increase in the volume of an organ or tissue due to the enlargement of its component cells. It is distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number. Although hypertro ...

is accompanied by some septum deviation, so the surgery is done along with

septoplasty Septoplasty (, "septum" + , "to shape"), or alternatively submucous septal resection and septal reconstruction, is a corrective surgical procedure done to straighten a deviated nasal septum – the nasal septum being the partition between the tw ...

Indications

A turbinectomy is usually performed to resolve turbinate hypertrophy, where the turbinates are swollen and enlarged. Common causes of this condition are

allergies Allergies, also known as allergic diseases, are various conditions caused by hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include Allergic rhinitis, hay fever, Food allergy, food al ...

, environmental irritants, or a

deviated septum Nasal septum deviation is a physical disorder of the nose, involving a displacement of the nasal septum. Some displacement is common, affecting 80% of people, mostly without their knowledge. Signs and symptoms The nasal septum is the bone and ...

Procedure

Traditional methods

There are many different techniques used in a turbinectomy, including

electrocautery Cauterization (or cauterisation, or cautery) is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage, remove an undesired growth, o ...

cryotherapy Cryotherapy, sometimes known as cold therapy, is the local or general use of low temperatures in medical therapy. Cryotherapy can be used in many ways, including whole body exposure for therapeutic health benefits or may be used locally to treat ...

(cryoturbinectomy), laser vaporization, and turbinoplasty. These require

general anesthesia General anaesthesia (UK) or general anesthesia (US) is medically induced loss of consciousness that renders a patient unarousable even by painful stimuli. It is achieved through medications, which can be injected or inhaled, often with an analgesi ...

Radiofrequency ablation

The use of

radiofrequency ablation Radiofrequency ablation (RFA), also called fulguration, is a medical procedure in which part of the electrical conduction system of the heart, tumor, sensory nerves or a dysfunctional tissue is ablated using the heat generated from medium fre ...

has shown to be a safer alternative, being performed as an

outpatient procedure A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other heal ...

, using

lidocaine Lidocaine, also known as lignocaine and sold under the brand name Xylocaine among others, is a local anesthetic of the amino amide type. It is also used to treat ventricular tachycardia and ventricular fibrillation. When used for local anae ...

for

local anesthesia Local anesthesia is any technique to induce the absence of sense, sensation in a specific part of the body, generally for the aim of inducing local analgesia, i.e. local insensitivity to pain, although other local senses may be affected as well. ...

. It does not alter the

epithelial Epithelium or epithelial tissue is a thin, continuous, protective layer of cells with little extracellular matrix. An example is the epidermis, the outermost layer of the skin. Epithelial ( mesothelial) tissues line the outer surfaces of man ...

structure or function. It causes no postoperative pain, bleeding, or crusting, though it can result in some temporary nasal blockage or

rhinorrhea Rhinorrhea (American English), also spelled rhinorrhoea or rhinorrhœa (British English), or informally runny nose is the free discharge of a thin mucus fluid from the nose; it is an extremely common condition. It is a common symptom of allergie ...

due to resulting inflammation.

Complications

Empty nose syndrome, one form of atrophic rhinitis, is a condition that can develop as a result of turbinate surgery or other surgeries that have an impact on the turbinates. It is a rare condition in which people whose nasal passages are clear following a turbinectomy experience a number of symptoms, including feelings of nasal obstruction, nasal dryness, and crusting, as well as a sensation of being unable to breathe, ''inter alia''.

References