Turbinate hypertrophy

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What is turbinate hypertrophy?

Turbinate hypertrophy is a medical condition in which the nasal turbinates, the mucosa-lined bony structures inside the nostrils, become abnormally enlarged. This hypertrophy can obstruct the nasal passages, making breathing difficult and affecting the quality of life of those who suffer from it. Turbinate hypertrophy causes reduced airflow through the nostrils, which can lead to symptoms such as chronic nasal congestion, shortness of breath and snoring.

Anatomy and function of the turbinates

Nasal turbinates are essential structures in the nasal passages. They are divided into three types:

  1. Superior turbinates: located in the upper part of the nasal cavity, they play a minor role in regulating airflow.
  2. Middle turbinates: located in the middle of the nasal cavity, they are crucial for ventilation and drainage of the sinuses.
  3. Inferior turbinates: the largest and functionally most important, they are located in the lower part of the nasal cavity and are mainly responsible for air filtration and humidification.

Function of the turbinates in breathing

Turbinate hypertrophy is relevant not only to nasal health, but also to general well-being. Obstruction of the nasal passages can interfere with sleep, cause daytime fatigue and affect concentration.

Who is most affected by this condition?

Turbinate hypertrophy affects a wide range of people, but is especially prevalent in those with chronic allergies, allergic rhinitis and other nasal sinus diseases. The nasal turbinates have several vital functions:

  1. Air filtration: they help filter particles and pollutants from inhaled air, thus protecting the lungs.
  2. Air humidification: they add moisture to the inhaled air, which prevents dryness of the airways.
  3. Inhaled air temperature regulation: They heat or cool the inhaled air, ensuring that it reaches the lungs at an appropriate temperature.
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What causes turbinate hypertrophy?

Genetic factors

Genetics can play a significant role in turbinate hypertrophy. Hereditary predispositions and genetic mutations can affect nasal structure and predispose a person to develop turbinate hypertrophy.

Environmental factors

Environmental factors are also crucial:

  1. Allergies: Both seasonal and perennial allergies can cause chronic inflammation of the turbinates.
  2. Chronic infections: Recurrent respiratory tract infections can lead to persistent inflammation.
  3. Environmental Pollution: Prolonged exposure to poor air quality and occupational hazards can aggravate the condition.

Nasal decongestants

Excessive use of nasal decongestants can cause rebound congestion, aggravating turbinate hypertrophy. Prolonged use may lead to dependence and further swelling of the turbinates.

Nasal septum deviation

A deviated nasal septum can contribute to turbinate hypertrophy by altering airflow and causing turbinate compensation. Common causes include nasal trauma and congenital defects.

Symptoms of turbinate hypertrophy

Symptoms of turbinate hypertrophy include:

  1. Persistent nasal congestion: difficulty breathing through the nose.
  2. Difficulty breathing through the nose: sensation of nasal obstruction.
  3. Snoring: caused by obstruction of airflow.
  4. Facial pain: sensation of pressure in the face.
  5. Ear Rrelated symptoms: sensation of fullness in the ears, tinnitus and ear congestion.
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Relationship between the turbinates and the ear

Nasal turbinates not only affect breathing, but can also have a significant impact on the health of the ear. Turbinate hypertrophy can:

  • Obstruct the Eustachian tube, the canal that connects the middle ear to the back of the nose and throat. This obstruction can lead to inadequate ventilation of the middle ear, causing a build-up of fluid and increased susceptibility to ear infections, such as otitis media. 
  • Cause a feeling of fullness in the ears, tinnitus (ringing in the ears) and ear congestion, affecting hearing and balance

Therefore, it is crucial to address turbinate hypertrophy not only to improve breathing, but also to prevent hearing complications.

Diagnosis of turbinate hypertrophy

Diagnosis of turbinate hypertrophy includes:

  1. Complete Medical History: evaluation of symptoms and medical history.
  2. Physical Examination: Inspection of the nasal passages.
  3. Nasal Endoscopy: Direct visualisation of the turbinates.
  4. Imaging studies: Such as computed tomography (CT) and magnetic resonance imaging (MRI).
  5. Allergy Testing: To identify possible allergic triggers.

What are the treatments for turbinate hypertrophy?

Non-surgical options include:

  • Medications: Antihistamines and nasal corticosteroids to reduce inflammation.
  • Nasal lavage therapy: To clear the nasal passages and reduce congestion.
  • Lifestyle Modifications: Avoiding allergens and improving indoor air quality.

Surgical options include:

  • Turbinate Reduction (Turbinoplasty): Procedure to reduce the size of the turbinates.
  • Radiofrequency Ablation: Use of radiofrequency energy to shrink the tissue.
  • Laser Therapy: Use of laser to reduce the size of the turbinates.
  • Microdebrider Techniques: Use of special devices to remove excess tissue.

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