
Turbinate reduction (also known as turbinoplasty) is a procedure that is commonly done along with septoplasty. In this article we answer common questions about having septoplasty and turbinate reduction surgery done at the same time.
What is Septoplasty and Turbinate Reduction Surgery?
Septoplasty is a surgical procedure performed to straighten the deviated nasal septum and turbinate reduction surgery is done to reduce the size of the enlarged turbinates (bony structures lined with mucosa) present on the lateral (side) wall of the nose. In many individuals, deviation in the septum is present along with overgrowth of the turbinates, causing nasal obstruction and narrowing of the airway. In such cases, the two surgeries are performed in conjunction to relieve nasal obstruction and restore the nasal airflow.1Kim, D. H., Park, H. Y., Kim, H. S., Kang, S. O., Park, J. S., Han, N. S., & Kim, H. J. (2008). Effect of Septoplasty on Inferior Turbinate Hypertrophy. Archives of Otolaryngology–Head & Neck Surgery, 134(4), 419.
Benefits of Septoplasty Turbinate Reduction Surgery
Benefits of septoplasty and turbinate reduction surgery are:2Han JK, Stringer SP, Rosenfeld RM, Archer SM, Baker DP, Brown SM, et al. Clinical consensus statement: septoplasty with or without inferior turbinate reduction. Otolaryngology–Head and Neck Surgery. 2015 Nov;153(5):708-20.3Karlsson TR, Shakeel M, Supriya M, Ram B, Ah-See KW. Septoplasty with concomitant inferior turbinate reduction reduces the need for revision procedure. Rhinology. 2015 Mar;53(1):59-65. doi: 10.4193/Rhin12.059. PMID: 25756080.
What to Expect After Septoplasty and Turbinate Reduction Surgery?
In this section we cover what you can expect when recovering from septoplasty and turbinate reduction surgery, along with recovery tips:
The following symptoms can be experienced by the patient after the surgery:4Bernardo MT, Alves S, Lima NB, Helena D, Condé A. Septoplasty with or without postoperative nasal packing? Prospective study. Braz J Otorhinolaryngol. 2013 Aug;79(4):471-4. English, Portuguese5Bielamowicz, S., Hawrych, A., & Gupta, A. (1999). Endoscopic inferior turbinate reduction: A new technique. The Laryngoscope, 109(6),
Research suggests that recovery after septoplasty and turbinate reduction surgery was achieved in 22-43 days. Swelling subsides within 1-2 weeks after the surgery following which patient can resume work. Complete recovery from symptoms due to nasal obstruction is observed after 1 year of the surgery. However, significant improvement can be observed even after 3 months of the surgery.6Dąbrowska-Bień J, Skarżyński PH, Gwizdalska I, Łazęcka K, Skarżyński H. Complications in septoplasty based on a large group of 5639 patients. Eur Arch Otorhinolaryngol. 2018 Jul;275(7):1789-1794.7Alotaibi A, Almutlaq BA, Ahmed HG. Time for Recovery of Symptoms after Septoplasty.
Below are recovery tips to fasten the healing after the surgery:8Dąbrowska-Bień J, Skarżyński PH, Gwizdalska I, Łazęcka K, Skarżyński H. Complications in septoplasty based on a large group of 5639 patients. Eur Arch Otorhinolaryngol. 2018 Jul;275(7):1789-1794.9Simpson JC. Postoperative Care of The Patient After Nasal Surgery
Septoplasty and Turbinate Reduction Complications
Here are some of the common complications/side effects of septoplasty and turbinate reduction surgery, and a brief description of each:
Mild to moderate pain is experienced by the patient post-surgery. The patient may experience pain and discomfort during retrieval of nasal splints (placed to support the nose), 1 week after the surgery. However, following post-surgery instructions such as the use of pain killer medication, applying a cold pack over the operated site, and sleeping with the head elevated using pillows can aid in better pain control.10Scheithauer MO. Surgery of the turbinates and "empty nose" syndrome. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2010;9:Doc03.11Bloom, J. D., Kaplan, S. E., Bleier, B. S., & Goldstein, S. A. (2009). Septoplasty Complications: Avoidance and Management. Otolaryngologic Clinics of North America, 42(3), 463–481.
Nasal congestion is common after septoplasty and turbinate reduction surgery for the initial 1-2 weeks. It could be due to the presence of swelling at the operated site or placement of nasal packing or splints after the surgery to support the nose. Sometimes patients with persistent nasal obstruction or nasal congestion may require revision surgery.12Joshi RR, Riley CA, Kacker A. Complication Rates Following Septoplasty With Inferior Turbinate Reduction. Ochsner Journal. 2019 Dec 21;19(4):353-6.
Mild to moderate swelling will occur for 3-4 days after the surgery and subside gradually. It may be accompanied by bruising or discoloration of the skin. However, the use of medications and placement of a cold pack or ice intermittently for 20 minutes for the first 48 hours after the surgery can fasten the recovery.13Simpson JC. Postoperative Care of The Patient After Nasal Surgery
The presence of nasal obstruction for a long duration can result in sinus infections, affecting the quality of life. The presence of deviated nasal septum and enlarged turbinates may affect the drainage of mucus and cause clogging (due to increase accumulation of mucus) of sinuses leading to sinus infections. So, this surgery reduces the incidence of sinus infections besides improving the nasal airflow. Overall, it is considered to be a safe and effective procedure.14Joshi RR, Riley CA, Kacker A. Complication Rates Following Septoplasty With Inferior Turbinate Reduction. Ochsner Journal. 2019 Dec 21;19(4):353-6.
The incidence of headaches is reported to be less after septoplasty and turbinate reduction surgery. The contact between the mucosa (inner skin) of deviated nasal septum and enlarged turbinates acts as a stimulus to produce pain, leading to headaches. So, performing septoplasty and turbinate reduction surgery eliminates these mucosal contacts, reducing the incidence of headaches. Research suggests that there is a significant improvement in the severity of headaches within 3 months after the surgery.15Lakshmanan, S., Singh, U., Zaffrullah, N. S., & Manimaran, V. (2020). Clinical Outcome Following Endoscopic Septoturbinal Surgeries for Rhinogenic Contact Point Headache: A Retrospective Analysis. Indian Journal of Otolaryngology and Head & Neck Surgery.
However, patients may complain of postoperative headaches for a week due to the presence of nasal packing.
Mild oozing of blood after surgery is common. Excessive bleeding after the septoplasty and turbinate reduction surgery is reported in ~6% to 13.4% of patients. The presence of this complication could be due to several reasons such as septal incision (cut on septum), technique opted to perform the surgery, lack of use of nasal packing, and surgeon-related differences. In case of severe bleeding contact your doctor immediately.16Bloom, J. D., Kaplan, S. E., Bleier, B. S., & Goldstein, S. A. (2009). Septoplasty Complications: Avoidance and Management. Otolaryngologic Clinics of North America, 42(3), 463–481.
Septoplasty and turbinate reduction video
Here are good videos that show the steps of the septoplasty and turbinate reduction procedures:
Frequently Asked Questions – Septoplasty and Turbinate Reduction Surgery
Here are answers to the most commonly asked questions related to septoplasty and turbinate reduction surgery:
Research suggests that average room time (time during which patient is present in the operating room) was reported to be ~110 minutes and average surgical time (time taken to perform surgery) was ~77 minutes.17Quinn, N. A., Alt, J. A., Ashby, S., & Orlandi, R. R. (2018). Time, Resident Involvement, and Supply Drive Cost Variability in Septoplasty with Turbinate Reduction. Otolaryngology–Head and Neck Surgery, 159(2), 310–314.
The total cost for septoplasty and turbinate reduction surgery ranges from $852 to $10,559. The cost may vary depending on the technique opted, complexity of the case, surgeon’s expertise, and operating room’s fees. The additional cost incurred ranges from $400 to $5,081.18 Thomas, A., Alt, J., Gale, C., Vijayakumar, S., Padia, R., Peters, M., … Meier, J. D. (2016). Surgeon and hospital cost variability for septoplasty and inferior turbinate reduction. International Forum of Allergy & Rhinology, 6(10), 1069–1074
Turbinal reduction surgery or turbinoplasty includes partial removal of the bone and the mucosa (skin) covering the turbinates. Meanwhile, turbinectomy involves the removal of the entire turbinates (entire bone and skin). This is associated with more crusting (increased accumulation of mucus) and delayed healing when compared to turbinoplasty.19Bhandarkar ND, Smith TL. Outcomes of surgery for inferior turbinate hypertrophy. Curr Opin Otolaryngol Head Neck Surg. 2010 Feb;18(1):49-53.
Sources:
- 1Kim, D. H., Park, H. Y., Kim, H. S., Kang, S. O., Park, J. S., Han, N. S., & Kim, H. J. (2008). Effect of Septoplasty on Inferior Turbinate Hypertrophy. Archives of Otolaryngology–Head & Neck Surgery, 134(4), 419.
- 2Han JK, Stringer SP, Rosenfeld RM, Archer SM, Baker DP, Brown SM, et al. Clinical consensus statement: septoplasty with or without inferior turbinate reduction. Otolaryngology–Head and Neck Surgery. 2015 Nov;153(5):708-20.
- 3Karlsson TR, Shakeel M, Supriya M, Ram B, Ah-See KW. Septoplasty with concomitant inferior turbinate reduction reduces the need for revision procedure. Rhinology. 2015 Mar;53(1):59-65. doi: 10.4193/Rhin12.059. PMID: 25756080.
- 4Bernardo MT, Alves S, Lima NB, Helena D, Condé A. Septoplasty with or without postoperative nasal packing? Prospective study. Braz J Otorhinolaryngol. 2013 Aug;79(4):471-4. English, Portuguese
- 5Bielamowicz, S., Hawrych, A., & Gupta, A. (1999). Endoscopic inferior turbinate reduction: A new technique. The Laryngoscope, 109(6),
- 6Dąbrowska-Bień J, Skarżyński PH, Gwizdalska I, Łazęcka K, Skarżyński H. Complications in septoplasty based on a large group of 5639 patients. Eur Arch Otorhinolaryngol. 2018 Jul;275(7):1789-1794.
- 7Alotaibi A, Almutlaq BA, Ahmed HG. Time for Recovery of Symptoms after Septoplasty.
- 8Simpson JC. Postoperative Care of The Patient After Nasal Surgery
- 9Scheithauer MO. Surgery of the turbinates and "empty nose" syndrome. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2010;9:Doc03.
- 10Bloom, J. D., Kaplan, S. E., Bleier, B. S., & Goldstein, S. A. (2009). Septoplasty Complications: Avoidance and Management. Otolaryngologic Clinics of North America, 42(3), 463–481.
- 11Joshi RR, Riley CA, Kacker A. Complication Rates Following Septoplasty With Inferior Turbinate Reduction. Ochsner Journal. 2019 Dec 21;19(4):353-6.
- 12Lakshmanan, S., Singh, U., Zaffrullah, N. S., & Manimaran, V. (2020). Clinical Outcome Following Endoscopic Septoturbinal Surgeries for Rhinogenic Contact Point Headache: A Retrospective Analysis. Indian Journal of Otolaryngology and Head & Neck Surgery.
- 13Quinn, N. A., Alt, J. A., Ashby, S., & Orlandi, R. R. (2018). Time, Resident Involvement, and Supply Drive Cost Variability in Septoplasty with Turbinate Reduction. Otolaryngology–Head and Neck Surgery, 159(2), 310–314.
- 14Thomas, A., Alt, J., Gale, C., Vijayakumar, S., Padia, R., Peters, M., … Meier, J. D. (2016). Surgeon and hospital cost variability for septoplasty and inferior turbinate reduction. International Forum of Allergy & Rhinology, 6(10), 1069–1074
- 15Bhandarkar ND, Smith TL. Outcomes of surgery for inferior turbinate hypertrophy. Curr Opin Otolaryngol Head Neck Surg. 2010 Feb;18(1):49-53.
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