Nasal Turbinate Surgery Can Help with Breathing and Headache Issues

The turbinates are structures inside the nose that are attached to the right and left walls of the nasal cavity. Turbinates have three primary functions: to warm, humidify, and filter air as it passes through the nose on its way to the lungs. Sometimes the turbinates become large, requiring surgery to reduce them to a normal size.

At University Hospitals Department of Plastic Surgery, we have surgeons who specialize in performing nasal turbinate surgery.

Turbinates and Migraines

Recent findings link nasal “contact points” with certain types of headaches such as migraines. Contact points occur when the turbinates come into contact with the wall that divides the nose into two chambers (the septum). Particularly when there is a sharp spur of the septum that contacts one or more turbinates, swelling of the turbinates can cause increased pressure against the spur and may cause a cascade of events that can result in a painful migraine headache.

Patient History and Examination

When symptoms such as difficulty in breathing through the nose or headaches are present, and when a physician examines the inside of the nose and sees enlarged or malpositioned turbinates, surgery becomes indicated. The turbinates are well-visualized and their relationship to the sinuses can be seen on a computed tomography (CT scan). UH physicians may ask patients about the following issues because they can be a factor with enlarged or malpositioned turbinates:

  • Nasal congestion/obstruction
  • Drainage
  • Allergies
  • Trauma
  • Previous nasal surgery
  • Sinus problems
  • Headache

The physician specialist at UH will examine the inside of the nose with a bright light and an instrument called a speculum, which gently opens the nostrils so the doctor can see inside. Sometimes, a flexible telescope is used to look deeper into the nasal cavity and better see the turbinates.

Ideal Candidates for Turbinate Surgery

The best candidates for turbinate surgery are symptomatic men and women with functional or anatomically abnormal turbinates who are physically healthy and who have realistic expectations.

Performing Turbinate Surgery

Turbinate surgery is performed entirely through the nostrils (except when a rhinoplasty is done in combination with turbinate surgery). No bruising or external changes in the shape of the nose should occur. When combined with rhinoplasty, the external appearance of the nose will be altered, and swelling and bruising of the nose and face may be evident. Turbinate surgery may also be combined with sinus surgery and/or septoplasty.

Turbinate surgery is usually done under general anesthesia and almost always done as an outpatient procedure.

Recovery

Following turbinate surgery, and depending on exactly what was done and how much bleeding occurred, packing may or may not be used. Traditional packing is with long, narrow gauze. Our surgeons are now using either tubes or a sponge-like material or dissolvable packing. The patients may have some bloody drainage from the nose for up to a week. There is no bruising or swelling with this surgery, and often the patients can resume work within a few days to a week. Patients can resume strenuous activities in two to three weeks.