INFERIOR TURBINATE

 WHAT IS AN 'INFERIOR TURBINATE'?

The nasal cavity is composed of some key elements 
- The nasal vault - which forms the basic structure of the nose
- The Septum- which divides the nasal cavity into the Left and Right side
- The Turbinates- There are usually three paired Turbinates on either side of the nose - Inferior, Middle, and Superior. rarely there may be a Supreme Turbinate above the Superior Turbinate
The INFERIOR TURBINATE is the lowest and most often the bulkiest Turbinate in the nose. It extends from the front of the nose (you can see this for yourself if you look into a mirror and lift up the tip of the nose - the balloon like structure that you on either side of your nose is the inferior turbinate)

What do Turbinates do?

The Turbinates are bony structures over which mucosa is draped. The Inferior Turbinate is a separate bone by itself. The mucosa draped over it contains typical upper airway mucosa which also contains secretory glands as well as microcilia (very thin hair like structures) on its surface.
The glands secrete mucus to keep the nasal passage moist.
The function of the Turbinates is to
  • Channelize the air we breathe to the back of the nose
  • Filter the air we breathe by catching particulate matter, dust and other substances
  • Humidify the air we breathe in so that it is comfortable for the lungs
  • Maintain the Nasal Cycle - alternate opening and closing of each nasal passage - at rest only one nasal passage breathes at a time - the process is called the 'nasal cycle'. 
The Cilia on the surface of the Turbinates are active structures- they push all the entrapped particles (now inside a mucus shell) and push it back to the throat. This is swallowed from time to time and destroyed by the acid in the stomach

Problems with Inferior Turbinate

Common problems with the Inferior Turbinate include
  • Atrophy - or reduced size sometimes associated with crusting and foul smell on account of a secondary infection. This may be the result of a surgery, cauterization, or malnutrition.
  • Hypertrophy - or enlargement of the Inferior Turbinate. 

Hypertrophy of the Inferior Turbinate 

is quite a common problem.  Common causes are - 

1. Allergy
2. Infection
3. Compensatory enlargement on account of nasal septal deviation to the opposite side
4. As a consequence of chronic misuse of nasal decongestants - this leads to gross enlargement of the Inferior Turbinates - a condition called 'Rhinitis Medicamentosa' and can sometimes be very difficult to treat.

TREATMENT OF INFERIOR TURBINATE HYPERTROPHY

  1. MEDICAL- Intranasal steroid, stoppage of nasal decongestants (in case they are the cause), oral medication like an antihistamine if required
  2. SURGICAL
  • Submucosal Reduction using a host of methods- diathermy, coblation, laser, cryo etc.
  • Surgical correction using a Microdebrider- which involves shaving off a portion of the Inferior Turbinate Bone plus underlying glandular mass using special blades submucosally
  • Surgical excision of the front portion of the Inferior Turbinate bone - done submucosally so as not to disturb the medial mucosal blanket of the Inferior Turbinate.
Complications of surgery
- Atrophic rhinitis
- Excessive crusting
- Empty Nose Syndrome - a complication which arises if too much tissue is removed from the medial mucosal surface of the Inferior Turbinate - though the nasal passage is clear the patient feels obstructed. It is very difficult to treat.

HOW TO MAINTAIN A HEALTHY TURBINATE ?

  • Regular nasal cleaning
  • Nasal douching/ Jal Neti- this helps to clear the nasal passage, removes crusts, reduces allergen count and helps to breathe better. Not to be done in the presence of and acute infection, severe blockage or in case it causes pain.
In Case of problems with your Nasal Turbinates kindly contact our Centre 
- D 3/14, Vasant Vihar. New Delhi 110057

Call- 9871150032





Location: D 3, 14, Vasant Vihar, opposite Vasant Vihar, Block D, Club, New Delhi, Delhi 110057, India

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