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Outfracture of Turbinates

Definition

Outfracture is a procedure to break the bone of the lower turbinate. Once completed, the turbinate may be moved. The turbinates are 3 paired sets of structures that line the inside wall of the nasal cavity. These structures filter, moisten, and heat air as it enters the nose. They are made of small bones that are surrounded by soft tissue.

Outfracture of turbinates may be done in combination with a septoplasty.

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Reasons for Procedure    TOP

Turbinates can become enlarged and make it difficult to breathe through your nose. Outfracture of turbinates can allow the turbinate to be moved to a different position to:

  • Relieve blockage in the nasal passages
  • Improve breathing through the nose by increasing air flow and moisture
  • Reduce postnasal drip and excess drainage

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Bleeding
  • Infection
  • Persistent nasal blockage or sinus problems
  • Change in your breathing
  • Numbness in your teeth or nose
  • Perforated septum
  • Altered smell, taste, or vision
  • Repeat procedures
  • Rare, but serious complications include toxic shock syndrome and meningitis

What to Expect    TOP

Prior to Procedure

Your doctor may do the following before your surgery:

  • Physical exam
  • Blood tests
  • Imaging tests to see internal nasal structures

Before your procedure:

  • Avoid eating or drinking after midnight the night before.
  • Talk to your doctor if you take any medications, herbs, or supplements. You may need to stop taking some medications up to one week before the procedure.

Your doctor will recommend that you stop smoking up to a month before the procedure. Smoking leads to an increase in scar tissue and poor healing that affects the success of the surgery.

Anesthesia

Depending on the extent of the surgery, you may have:

Description of the Procedure    TOP

The surgeon will insert an endoscope into your nose. An endoscope is a thin, lighted tube with a camera. The small bone inside the turbinate will be broken and pressure will be used to move it to the side wall of the nose.

The remaining tissue may thinned-out around the turbinate. Bleeding can be stopped using electrical heat, radiofrequency, stitches, or packing.

How Long Will It Take?    TOP

1-2 hours

Will It Hurt?    TOP

Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.

Post-procedure Care    TOP

At the Care Center

Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:

  • Pain medications
  • Decongestant nasal sprays
  • Antibiotics to prevent infection
  • Medication to prevent blood clots

At Home

The feeling of stuffiness is common after surgery because of swelling. Nasal sprays will help keep your nasal passageways moist, clean debris like dried blood, and assist in healing.

Call Your Doctor    TOP

It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:

  • Signs of infection, including fever and chills
  • Increase in bleeding or discharge
  • Vision problems
  • Severe headache or neck stiffness
  • Persistent nosebleeds

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Academy of Otolaryngology—Head and Neck Surgery
http://entnet.org
Family Doctor—American Academy of Family Physicians
http://familydoctor.org

CANADIAN RESOURCES:

Canadian Society of Otolaryngology
http://entcanada.org
The College of Family Physicians of Canada
http://www.cfpc.ca

References:

Brunworth J, Holmes J, Sindwani R. Inferior turbinate hypertrophy: Review and graduated approach to surgical management. Am J Rhinol Allergy. 2013;27(5):411-415.
Kerzirian, E. Turbinate surgery. Sleep Doctor website. Available at:
...(Click grey area to select URL)
Accessed November 28, 2017.
Reduction of turbinates. ENT Consent Patient Resource website. Available at:
...(Click grey area to select URL)
Accessed November 28, 2017.
Septoplasty & turbinate surgery. American Rhinologic Society website. Available at:
...(Click grey area to select URL)
Accessed November 28, 2017.
Turbinate reduction. Johns Hopkins Sinus Center website. Available at:
...(Click grey area to select URL)
Accessed November 28, 2017.
Last reviewed November 2017 by EBSCO Medical Review Board James Cornell, MD

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