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You're not the only one…According to H. Dugan’s “Bedlam in the Boudour” (1947): “Twenty of thirty-two Presidents of the Unitied States are proved or believed on a thick web of circumstances to have been nocturnal nuisances in the White House” and “President Theodore Roosevelt once snored so loudly in a hospital that complaints were filed by almost every patient in the wing where he was recuperating”
Home Surgical Procedures Coblation Coblation Turbinate Reduction
Radiofrequency Turbinate Reduction Print E-mail
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Many people with nasal blockage or congestion are due to enlargement of the turbinates. These are located in the nose along the sides of the nasal cavity. They are responsible for the suffy nose when you are sick, cause your nose to block off on the side you are sleeping on, or cause the alternating nasal congestion in many of my patients. They swell in response to allergies, chemical exposure, smoking, and for many other reasons.  Although treating nasal obstruction rarely results in complete snoring relief, it is an important part of ensuring long term relief from other procedures and in relieving many other symptoms from nasal obstruction. This includes improvement in nasal congestion, morning post-nasal drip, mouth breathing, and dry mouth and throat in the morning.

The goal of turbinate surgery is to increase nasal airflow while preserving the normal function. The turbinates have a major role in adding humidity to the air we inspire and in filtering the air. The lining of the turbinates contains cilia, which are small hairs that beat to move the mucous (which has trapped debris) in our nose. Venous sinusoids are blood vessels which lie under the surface of the turbinates to add moisture to the air we breathe in. This makes sure the air is clean and moist – just perfect for our lungs.

The key to ensuring normal function is mucosal preservation – which means keeping the lining of the nose intact. Traditionally, we have used electrocautery techniques placed below the surface of the nose.

Cautery Device
Electrocautery reaches high temperature to cause destruction of tissue by boiling and coagulation. It results in unpredictable collateral damage, pain, and recovery time. The swelling or inflammation can be prolonged, the cilia and glands may be destroyed leading to nasal crusting, and the underlying bone has occasionally died (Willimas et al. J Laryngol Otol, 1991). New techniques to reduce the turbinates have involved keeping the temperature low to create more precise surgical techniques which limit collateral damage. There is therefore less pain, quicker recovery, less time off work, and less complications.

Radiofrequency is a surgical device which allows shrinkage of tissue under the lowest of temperatures.

Coblation Device
Studies show that the energy delivered is much more predictable and the surface lining of the turbinates (cilia) remains normal and functioning 1 year after treatement (Elwany, Am J Rhinol, 1999). Healing is also twice as fast (7 days versus 14) when complared to cautery (Chinpairoj et al, Laryngoscope, 2001).

How happy are patients with coblation? The evidence for this is variable but overall, 89% of patients are satisfied and would have the procedure again (Atef et al, Am J Rhinol, 2000; Back et al. Am J Rhinol 2006 ; Bhattacharyya et al, Otolaryngol Head and Neck Surg, 2003).
Complication rates:  About ¼ of patients have some discomfort during the procedure, especially if the back part of the turbinates are done. About 1/3 will have some blood tinged mucous on Kleenex when they blow their nose. About 1/50 patients (2%) have more rapid bleeding which requires packing to be placed in the nose.