The structures that are attached to the sides of both nasal cavities, which are in the form of a tunnel, and extend like fingers from front to back, are called nasal conchae. (picture) These are located in three rows, one on top of the other, as the upper, middle and lower nasal conchas. Turbinates have many functions such as warming, filtering and humidifying the respiratory air, smelling and ensuring that both nostrils work in turns (nasal cycle). Due to various reasons, these nasal conchas (especially the lower nasal conchas) may be larger than normal and make breathing difficult. (picture) In patients with nasal bone curvature (septum deviation), it is common for the lower nasal concha on the side of the wide nostril and sometimes the middle nasal concha to be larger than normal (turbinate hypertrophy). (picture)
The lower nasal concha are structures that contain a thin bone plate and are covered with a spongy tissue densely containing blood vessels. If the nasal concha that has enlarged for various reasons cannot be reduced with medication, it may be necessary to reduce it with surgery. There are many surgical methods to reduce the size of the turbinates: Complete removal of the turbinate, partial removal, removal of the bone inside, breaking it and pushing it to the side wall, shrinking it with radiofrequency...
Except for very rare and special cases, completely removing the turbinates is inconvenient and is not performed today. The most practical and up-to-date method for reducing the size of turbinates is "Radiofrequency" application. Here, a sharp metal called electrode is inserted into the turbinate and radiocurrent is applied to several points. Radiocurrent creates a slight burn through the controlled application of heat within the tissue and causes the spongy tissue, which can swell by filling with blood, to shrink and harden. Thus, permanent shrinkage of the turbinate is ensured. Depending on the device used, one to three sessions are sufficient. The effectiveness of radiofrequency application usually becomes fully evident 1-2 months after the procedure. While radiofrequency application is generally performed as an accompaniment to septoplasty surgeries (while the patient is already under anesthesia), it can sometimes be performed alone. If only radiofrequency will be performed, it can also be performed under local anesthesia (without anesthesia). It is a painless and short procedure and does not require hospitalization afterwards. It usually does not require a nasal tampon and the person can return to normal work and daily life on the same day.
In the first few days after the radiofrequency procedure, blockages occur due to edema and accumulation of dark sticky discharge. Afterwards, a period of crusting and drying may be observed that lasts for 2-3 weeks and gradually decreases. During this period, it is recommended to clean the nose by washing it and moisturizing it with suitable products. Wound healing is completed in approximately 1 month.
WHAT IS MIDDLE TURBICAL ENLARGEMENT (CONCHA BULLOSA)?
The bone plate within the middle nasal concha sometimes contains an air gap. (Picture normal and pathological) It is in the form of two shells stuck together, just like an apricot seed. Air in the middle turbinate (middle turbinate pneumatization) can be seen in 25-40% of people who have no complaints, so it is not a disease. However, if the middle turbinate is large enough to prevent breathing, causes sinusitis by closing the sinus channels, or causes pain by contacting other places in the nose (MKBA = Mucosal Contact Headache), it must be reduced surgically. What is generally done here is to cut and remove the outer part of the two shells, which resemble apricot seeds. The surgery is performed endoscopically, that is, by entering the nose with thin optical instruments. It is an easy and trouble-free process when done carefully. In some cases, bleeding, crusting and decreased sense of smell may occur after the procedure.
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