Nasal Turbinates (Concha)

Many patients with ENT disorders seek medical advice due to nasal congestion and swelling of the nasal turbinates (concha). Nasal turbinate enlargement, which can cause significant breathing problems, particularly at night, may sometimes occur without any apparent reason. Additionally, it can also develop as a result of allergic conditions. When the nasal turbinates encounter an allergic trigger, they can enlarge by a few millimeters due to the increased blood flow. Enlargement can also occur due to certain nasal inflammations. Nasal turbinates can also grow as a natural part of aging.

Fatigue Unexplained by Other Causes May Be Due to Nasal Turbinates

As the nasal turbinates enlarge, patients first experience nasal congestion. They may then begin sleeping with their mouth open at night and experience dry mouth upon waking. Since the patient receives less oxygen during the night, drowsiness may persist even after 7-8 hours of sleep, leading to daytime fatigue.

Medicated Method and Radiofrequency Method for Nasal Turbinates

Sprays containing special substances can be used to reduce the size of the nasal turbinates. However, these sprays should not be used for more than 5-6 days. It is important to note that these sprays do not have a therapeutic effect in reducing nasal turbinate size. Radiofrequency, used in nasal turbinate treatment, is a shrinkage method. Radiofrequency energy is applied to the nasal turbinates under local or general anesthesia, reducing their volume. Nasal turbinates treated with this method may grow back.

THE NIGHTMARE OF THE NIGHT: NASAL TURBINATES

Swelling of the nasal turbinates (concha), which are rich in vessels capable of expanding and contracting, leads to nasal congestion.

Allergies, air pollution, smoking, alcohol consumption, pregnancy, and NASAL SPRAY ADDICTION are the most common causes of nasal mucosal swelling.

Depending on the severity of the congestion, patients may sleep with their mouth open, snore, and, more importantly, experience brief episodes of breathlessness. For these patients, the night becomes a nightmare. Mouth breathing throughout the night causes dry throat, bad breath, a coated tongue, reduced taste sensation, as well as tickling and coughing fits.

medical treatment for nasal turbinate enlargement should be targeted at the cause.

• We should avoid smoking and alcohol consumption and refrain from using vasoconstrictor nasal drops for more than three days.
• Antihistamine allergy medications increase drowsiness. When taking these medications, we should avoid activities requiring attention, such as driving.
• Decongestant (vasoconstrictor) drugs increase heart rate and blood pressure. Individuals with heart disease, high blood pressure, glaucoma, or difficulty urinating should avoid these medications.
• Ephedrine nasal sprays, often used unconsciously by patients, cause irreversible damage to the nasal passages. These drugs should not be used for more than three days, as they are highly harmful.

Nasal Valve Surgery

The areas with the highest airflow entering the nose are the internal and external nasal valves, which form the soft tissue portion of the nose.

Narrowing or collapse of the valves leads to difficulty in nasal breathing (nasal valve insufficiency), which is one of the main causes of nasal congestion. Nasal valve surgery is based on the principle of eliminating the narrowing of the nasal valve and improving airflow in the region.

Causes of Nasal Valve Insufficiency

The causes of nasal valve insufficiency include: incorrect rhinoplasty or septoplasty, trauma affecting the nose, septal deviations, congenital weakness in nasal structures, and conditions such as cleft lip and facial paralysis.

Symptoms of Nasal Valve Insufficiency

Nasal valve insufficiency generally presents with the following symptoms:

• Sleeping with the mouth open due to nasal breathing difficulties
• Throat dryness caused by sleeping with the mouth open
• Snoring
• Weakness and fatigue
• Aesthetic issues in the appearance of the nose (asymmetry at the nasal entrance, collapse of the middle soft tissues of the nose)

Diagnosis of Nasal Valve Insufficiency

In diagnosing nasal valve insufficiency, other methods besides physical examination can be used for a definitive diagnosis. These include the Cottle Maneuver Test, Acoustic Rhinometry, and Rhinomanometry tests, where the patient’s breathing is assessed for relief by placing both index fingers at the junction of the nose and cheek and gently pulling them toward the ears.

Nasal Valve Surgery

Nasal valve insufficiency surgery is a highly successful and permanent method for treating nasal valve insufficiency. It can be used not only to widen the valve angle but also to correct problems in other nasal structures.

Depending on the situation, local anesthesia, sedation, or general anesthesia may be used for nasal valve surgery. The cartilage used to enlarge the valve area is typically taken from the septum or ear. It is then shaped and placed in the dorsal region of the nose, where it is fixed with sutures.

After Nasal Valve Surgery

After nasal valve surgery, a bandage is placed on the nose for 1 week. The tampons placed in the nose are removed 1-2 days after the operation. Swelling on the nose for an average of 1 month after the surgery is normal.