Nasal Concha Growth (Concha Hypertrophy) And Its Treatment

In the treatment of obstructions caused by the enlargement of the lower concha (concha hypertrophy) and usually causing more complaints at night, the reduction of the concha can be achieved with different methods. The lower nasal meats, which have a very important place in the functions of the nose, should never be completely cut and removed. Following such surgeries, which were frequently performed in the past, nasal functions deteriorate, and it is extremely difficult, sometimes even impossible, to resolve complaints such as dryness, crusting, recurrent infections and burning sensation in the nose, as well as negative results in respiratory physiology. For this reason, techniques that do not harm the functional outer surface mucosa are preferred while reducing the lower meat.

What are the causes of enlarged nose meats?
One of the leading causes is septum deviations. Compensatory hypertrophy occurs in the concha opposite the deviation side. In the deviation of the septum, the nasal cavity on the deviated side narrows, while the nasal cavity on the other side expands. Since the body does not want a very large cavity, it compensates for the width by enlarging the lower turbinate. For this reason, concha reduction surgeries must be performed together with septum deviation surgeries.
In addition, hypertrophies can be seen in the lower turbinates for reasons such as allergic nasal diseases, vasomotor rhinitis, those who use decongestant nasal drops such as continuous ephedrine, those who have frequent flu infections, granulomatous diseases of the nose, sinusitis and those who work in places with bad weather conditions.

What are the symptoms of enlarged nose meat?
The most common symptom is nasal congestion. It bothers people more, especially at night. The obstruction is usually not unilateral. Sometimes it goes to the right and sometimes to the left. Patients sometimes complain that they experience fullness and congestion in the ears along with nasal congestion. Head and face pain and dry throat may accompany the complaints. The quality of life of people decreases and they desire to breathe easily through the nose.

How is the diagnosis made?
Nose enlargements are easy to diagnose. Diagnosis can be easily made by traditional examination of the nose. However, in localized enlargement of the posterior tail parts of the turbinates, it is not possible to diagnose with classical examination methods. In these cases, endoscopic examination is required. Thus, the diagnosis is made. However, if the growth in the inferior turbinate is not related to the soft tissue and is due to the growth in the bone of the turbinate, computed tomography of the inferior turbinate should be performed for differential diagnosis. Because, in hypertrophies due to bone growths, it is necessary to remove a part of the bone by surgery. Otherwise, the surgery will fail.

How is it treated?
Treatment options are divided into two.
1.      Medical treatment (Reducing the concha with medication)
2.      Reducing the conchae with surgical interventions
a. Laser reduction
b. Reduction with electrocautery
NS. Reduction with radiofrequency surgery
D. There are many surgical methods such as inferior turbinoplasty.

When should drug therapy be administered?
Drug therapy is effective in mucosal hypertrophies of the inferior turbinate and should be used. It should be given in mild to moderate cases. However, the method and duration of use are important here. There is no benefit in short-term use. Usage should not be less than one month. More locally effective cortisone nasal sprays should be used. Other medications can be added if needed.
Important note: Nasal drops with ephedrine should not be used for more than one week. Because they are addictive and disrupt the functions of the turbinate.

What is Radiofrequency surgery in nasal concha enlargement?
Radiofrequency surgery is a method that has been used recently. In addition to lower turbinate mucosal hypertrophies, it is also used in the reduction of soft palate, tonsils and tongue root. However, it is the lower turbinate mucosal hypertrophies that are most effective among them.

Application method and advantages;
1.      Applicable in hospital and private examination
2.      Local anesthesia is sufficient
3.      Repetitive applications can be made
4.     Application may take up to 5-10 minutes
5.      No bleeding and no tampon needed
6.      Can go home and continue work on the same day
7.      For this reason, it is widely applied in the world

Are there any dangers of nasal surgery?
As in any surgical intervention, there may be some complications such as bleeding, adhesions and infection. However, if you are careful, there will be no problems.
The most important problem in lower turbinate surgery is the removal of the entire turbinate. Normally, today, there is no surgical approach in which the turbinate is completely removed, except for cancers. Removal of the entire turbinate is extremely inconvenient and should never be done. Empty nose syndrome occurs in patients whose turbinates are completely removed. Patients complain of not being able to breathe even though they are breathing. Treatment is also not possible.

Does the growth of the nose meat repeat?
After a certain period of time after lower turbinate surgeries, there may be partial growths in the soft parts of the turbinates. This situation is seen more after radiofrequency and it may be necessary to intervene again. However, in patients who have undergone turbinate surgery, if the surgery is performed in efficient and experienced hands, there is no growth to obstruct the respiratory tract. Bone tissue has already been taken. Slight growths that may occur in soft tissue do not affect respiration much.