Inferior Turbinate Reduction Procedure and risks?

Question

Hi, I'm scheduled to have Septoplasty with Inferior Turbinate Reduction to relieve nasal obstruction. I am concerned about developing Empty Nose Syndrome (ENS) after the procedure. Is ENS something I should be concerned about enough to cancel the procedure

Donald B. Yoo, MD, FACS · Answer

Your concerns are certainly worth sharing with your surgeon.  Due to the risk of empty nose syndrome, most surgeons are conservative with the amount of tissue removal during inferior turbinate reduction, and rarely will the turbinate be removed entirely.  When the turbinate is not removed, the risk of developing ozena is exceedingly low.  By discussing this concern with your surgeon, he/she can choose the appropriate technique of reducing your turbinates.

Ivan Wayne, MD · Answer

Thank you for your question. In my practice I have had the unfortunate experience of caring for patients that have had their turbinates removed by other doctors. These have been very miserable patients. There is little that can be done once empty nose syndrome has occurred. I think there is a complex relationship between the size of the turbinates and our ability to sense resistance when we breath in. If you remove too much turbinate tissue the nose lacks the sense of airflow. Nobody knows what the right amount of tissue to remove is. In general we are very conservative in our practice and I rarely remove any turbinate tissues, preferring to move (lateralize) the turbinate so that is less in the way of the airflow through the nose.You need to ask your surgeon specificially what their plan is for you.I hope this helps.

A. Joshua Zimm, MD · Answer

Empty Nose Syndrome is extremely rare, so I wouldn't recommend cancelling the procedure based on that concern.  You should find out from your surgeon exactly what kind of inferior turbinate reduction you are having.  If they aren't removing any turbinate tissue the likelihood of empty nose syndrome becomes infinitesimal.  They may be planning only to out fracture the turbinates or perform a radiofrequency procedure to shrink the mucous membranes or a combination.  Best of luck.

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