Our nose consists of bone, cartilage, skin cover, fatty tissue, muscle tissue, connective tissue, fibers and fascia. There are organs called turbinates on both sides of our nose. There are 3 or 4 pairs of inferior turbinates, middle turbinates, superior turbinates and sometimes the 4th pair, the supreme turbinates, on the right and left. While the lower and middle turbinates are independent, the upper turbinates are attached to the middle turbinates.
The turbinates consist of the innermost bone lamellae, cavernous structures formed by blood vessels around them, and the mucosa that surrounds them like a membrane. There are receptors on the surface of the turbinates that measure air flow and temperature.
Turbinates are erectile organs that fill and discharge with blood. They can grow up to 3-4 times their normal size in their own structure or in disorders of the septum, which is located in the middle of the nose, popularly called the nasal pole.
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Inferior turbinate is the most important organ in the nasal respiratory tract. It determines the amount and style of air flow through the nose by growing and shrinking. It warms the air by increasing blood flow in cold weather, and humidifies the air by increasing secretion in dry weather. If it cannot perform these functions in a balanced manner, various diseases occur.
The middle turbinate is essentially the center of the nasal sinuses. It is effective in the ventilation of the sinuses, the sinus secretion flow and the air being transmitted upwards to reach the olfactory area and smell. In middle turbinate diseases, there are usually complaints of headache, sinusitis and loss of smell. The special condition of the middle turbinate is turbinate bullosa disease and its treatment is endoscopic surgery.
- Turbinate hypertrophy (growth)
- Allergic rhinitis (hay fever)
- Vasomotor rhinitis
- Atrophic rhinitis
In turbinate diseases, there are generally complaints of nasal congestion, discharge, and sneezing. Treatment is surgery or drug therapy.
Drug treatment is sprays or pills.
Sprays
- With antihistamines
- Steroids (with with cortisone)
- Antihistamine and steroid mixture (not available in our country yet)
Pills
- Drugs with cortisone
- With antihistamine medicines
- Montelu cast sodium
- Decongestant drugs
Drugs other than the decongestant group provide relief due to shrinkage of the turbinates and decreased secretion.
Decongestant drugs cause vascular contraction. They provide relief in breathing by reducing the blood in the turbinate and reducing its volume.
Surgical treatment
- Surgical reduction of the turbinates
- Radiofrequency , cautery, coblator, plasmakinetic etc. Reducing the turbinates with devices
- Opening the respiratory tract by bending the turbinates outwards. (turbinate lateralization)
The physician should select and apply the appropriate treatment according to the patient's condition.
Vasomotor rhinitis: relatively more I would like to specifically talk about this disease because it is rare and there may be gaps in diagnosis and there are differences in treatment. Vasomotor rhinitis is a disease in which the turbinates respond excessively to changes in air temperature and humidity, causing runny nose due to increased secretion and nasal congestion due to the increase in turbinate volume. .
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