Anatomy / Physiology
The turbinate’s are folds of mucosa and bone that exist on the lateral wall of the nose. Their absolute function is uncertain but clearly they contribute to the other functions of the nasal mucosa.
- Warming the air
- Filtering the air
- Moistening the air
- Immunological presentation
- Assisting the sense of smell
Clearly however, the turbinates the are bony protrusions from the lateral nasal wall with mucosa overlying them and if this mucosa swells then they can cause a degree of nasal obstruction.
Submucosal Diathermy to the Inferior turbinates (SMDIT’s)
This surgical procedure is aimed at either superficial or deeper cautery to the mucosal layer overlying the bony inferior turbinate. This theoretically shrinks back the mucosa, causes some scarring and improves the nasal airway. It is common for this too cause significant airway obstruction for the first week postoperatively and then some improvement of symptoms. A similar technique using the laser can be employed. As this surgery is aimed at improving nasal obstruction if the patient has a deviated septum it is often combined with a septoplasty .
This surgical procedure requires removal of part or all of the inferior turbinate surgically. This is associated with occasional heavy nosebleeds and although is still performed is not frequently undertaken.
Degloving of the Inferior turbinates
This surgical technique involves the removal of the swollen mucosa overlying the bone of the inferior turbinate and leaving it to heal with fibrosis and scarring. It requires nasal packing and a course of oral antibiotics postoperatively.