I was thinking about getting a turbinate reduction since my nose congestion has been unbearable lately.

Question

I was researching side effects of turbinectomy and came across a few sites that mention Empty Nose Syndrome. What are the chances that if I have my turbinates reduced that I end up with this syndrome? If I did end up with Empty Nose Syndrome, what treatments are available for it? If you do recommend turbinate surgery, what type of procedure do you recommend to shrink them?

Jeffrey H. Spiegel, MD · Answer

Turbinates can be excised - which can possibly lead to empty nose syndrome However, if they are reduced by being lateralized or fractured it is extremely unlikely.  That works well.  It's worth seeing a facial plastic surgeon for an opinion.

Fred J. Bressler, MD, FACS · Answer

Thanks for your post. Septoplasty and bilateral partial turbinate reduction procedures are commonly performed surgeries for patients suffering from nasal obstruction, congestion, deviated nasal septum and enlarged inferior nasal turbinates which have not responded to medical or allergy therapy. When performed correctly the nose will not be "empty".Empty nose syndrome is a rare condition associated with patients who unfortunately have had radical traditional or endoscopic sinus surgery or inappropriate total removal of many normal intranasal structures including, inferior, middle and sometime supreme turbinates in conjunction with aggressive management for chronic sinusitis. An experienced and skilled ENT may recommend a conservative inferior turbinate reduction, along with correct for a deviated septum. You may wish to check the American Academy of Otolaryngology - Head and Neck Surgery (AAOHNS) website for more information about risks, benefits and complications for these services. Overall, patient satisfaction and safety scores are high for septoplasty and turbinate surgery. Best wishes.

Somyos Kunachak, MD - Account Suspended · Answer

Hi dalack,

The common causes of nasal obstruction are enlargement of the turbinate and deviation of the septum, however, there are still other possible causes such as nasal polyp, tumor, or congenital narrowing of the back part of the nasal passage. These should all be ruled out first  because each condition has a different treatment. 
For enlargement of the turbinate, the simplest way that will least likely cause Empty Nose Syndrome, is laser or radio frequency turbinate reduction, and these are both minimal invasive, yet effective approaches.

Dominic Castellano, MD - Account Suspended · Answer

Hello dalack,
You are referring to inferior turbinate reduction. There are various techniques that can be utilized to accomplish this: inferior turbinate submucus resection (SMR), inferior turbinate coblation or direct resection of mucosa and bone. The SMR technique combined with out fracture of the turbinate is really the gold standard for reducing the size consistently. This is normally accomplished by using what is called a microdebreeder or shaver. This instrument has a blade that oscillates back and forth. It essentially reduces the submucosa like a pac man (if you remember the video game). If done properly there should be no damage to the mucosa on the outside. Empty nose syndrome occurs when excessive turbinate tissue (inferior as well as middle turbinates) are overly resected. Inferior turbinate SMR is a very effective technique to improve airflow so long as the septum is not causing any functional obstruction. Good luck.
Dr. Dominic

I was thinking about getting a turbinate reduction since my nose congestion has been unbearable lately.

Answers (4)

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