Should I get Coblation Turbinate Reduction only? (Photo)

Question

I'm 41, male, with a crooked lower (caudal) septum and large nasal turbinates. I have difficulty breathing freely from one nostril and hourly It gets blocked with clear snot. This gets tiresome at night when I sleep. As I look at my options, I see expensive risks with getting a SeptoRhinoplasty from the wrong surgeon. I'm tempted to get immediate relief with coblation turbinate reduction for $1,500 while I keep looking for the right surgeon. Is the coblation turbinated reduction a safe bet?

Manish H. Shah, MD, FACS · Answer

Hello DeviatedSeptumTurbinateRed,Thanks for your question.I would wait until you find the right surgeon to perform coblation and septoplasty.With your severely deviated septum, airflow asymmetry creates asymmetric exposure issues for your turbinates making them react to the environment differently.  If you just perform coblation, you haven't addressed the cause, only the effect.  Your turbinate procedure probably won't be successful long term.Unless you don't have health insurance or you have a huge deductible, it would be pretty easy to get this covered as functional nasal surgery (septoplasty, inferior turbinate reduction.)  In reality, fixing the septal deviation will make turbinate reduction more successful in the long term.There are a bunch of great rhinoplasty surgeons in LA, so finding one who can take your insurance shouldn't be difficult.If you don't have insurance, then take your time to find the right surgeon and don't split up the procedure.Good luck,Dr. Shah

Michael A. Persky, MD · Answer

Hi Deviated,I have found radio frequency volumetric tissue reduction (Somnoplasty of the inferior nasal turbinates) very effective at improving nasal breathing in patients with nasal obstruction.  My rate of taking patients to the operating room for nasal obstruction caused by deviated septum has decreased by 50-70%.  If you are only concerned about breathing better and not about the cosmetic appearance, then by all means I would recommend Somnoplasty of your inferior turbinates.  Choose your treating physician most carefully.  Good luck and be well.Dr. P

William Portuese, MD · Answer

There are many issues inside the nose that can cause nasal obstruction such as turbinate hypertrophy, deviated nasal septum, allergies, chronic sinusitis, valve collapse and vestibular stenosis. Each one of these issues are treated  With medications or surgery. A thorough examination of the internal and external portion of the nose is required to determine the extent of turbinate hypertrophy. When the turbinates are enlarged and blocking air flow, there are many different maneuvers to reduce  them which include Coblation. Each one has its own advantages and disadvantages.  Whatever technique is used to reduce the turbinates takes weeks  to take effect. Overdoing the turbinate reduction can cause empty nose syndrome, so proceed carefully and find the right  doctor.

David Reinstadler, MD · Answer

I think functional nasal surgery may be needed in your case based on your description. I would recommend visiting with a few nasal surgeons (mostly ENT surgeons do functional septoplasty and turbinate reduction) and see what they recommend after an examination of your nose. Coblator assisted turbinate reduction takes some time to shrink down, so it is not always an immediate effect. I always recommend combining procedures, such as septoplasty and turbinate reduction, to reduce the number of times you need to undergo anesthesia. Best of luck

Arian Mowlavi, MD, FACS (license on probation) · Answer

In order to improve breathing and aesthetics you need to perform turbinate reduction and anterior septal transposition from the right to the left. Both of these procedures are straight forward and do not require separate surgeries nor separate surgeons.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and from the one photo without an examination you would clearly benefit from a septorhinoplasty associated with turbinate reduction if they are enlarged. The deviated septum appears to be blocking your airway on one sideDr Corbin

Michael Elam, MD (retired) · Answer

Dear deviatedseptumturbinatered, You will need an examination to determine the exact causes of your breathing difficulties and then a surgical plan is put into place. Your septum appears clearly deviated and it is more then likely a large component of your breathing difficulty. As far as your turbinate reduction is concerned, I prefer to use a surgical technique versus coblation of the turbinates. When operating on the turbinates I prefer a more non aggressive technique where you remove a portion of the turbinates so that the patient does not get empty nose syndrome. With coblation you can not always have precise control. I perform approximately three to four septorhinoplasty with reduction of turbinates cases weekly and this is a very standard procedure in the hands of a surgeon with expertise in this field. Best regards, Michael V. Elam, M.D.

Should I get Coblation Turbinate Reduction only? (Photo)

Answers (7)

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