Lateral wall of the nose
Fig. 1: Radiofrequency energy is sent below the superficial layer of the turbinate.
Fig. 2: The treated tissue is heated to a temperature of 70-75ºC to create a coagulation area.
Fig. 3: During the following three to six weeks, the treated tissue will shrink.
What are the causes of nasal obstruction?
In children, the most common cause is an enlargement of the adenoids or vegetations, which is often associated with an enlargement of the tonsils. (see sections "El niño roncador" and "Laser treatment").
In adults, there are two causes, which are often linked:
- Excessive enlargement of the inferior nasal turbinates.
- Displacement of the nasal septum, i.e. the wall that separates the two nostrils or sides of the nose.
Other causes may include hay fever, sinusitis and nasal polyps.
How is it diagnosed?
We determine the cause of nasal obstruction by means of nasal endoscopy, which is performed at our own surgery without causing any major discomfort. Based on this, we determine the most appropriate treatment. This technique allows us to visualise all structures of the nose and throat: mouth, pharynx and larynx. In addition, the images can be displayed on a screen in order to explain them to the patient and their chaperones.
How is it treated?
The treatment depends on the cause:
In the case of hypertrophy of the turbinates, we recommend reducing the size of the turbinates. This can be done by means of two different techniques:
- If the enlargement is moderate, we can reduce the size of the turbinates by means of radiofrequency treatment, a technique which is applied at our own surgery under a local anaesthetic. (Fig. 1, 2, and 3)
- If the enlargement of the turbinates is severe, their reduction by means of a CO2 laser is recommended. This technique is usually applied under a general anaesthetic. In contrast to other techniques, with which the turbinates can begin to grow again after a couple of years, the result is usually permanent. (Fig. 4 and 5)
In cases where the nasal septum is displaced, we correct the displacement in an intervention called septoplasty. This allows us to place it in a straight position and to achieve a flow of air on both sides of the nose.
If sinusitis is present, either because of a displaced septum or due to hypertrophy of the turbinates, we correct it by means of nasal endoscopic surgery. This allows us to perform the operation without leaving any external scars. The use of microscopic instruments allows us to prevent complications and to cause minimal or zero postoperative discomfort.
In the case of nasal polyps, we eliminate them by using endoscopic techniques. This allows us to avoid haemorrhage and postoperative complications and leaves no scars. The polyps are extracted by means of a microdebrider, a device which causes no lesions to healthy tissue.
Endoscopy allows us to gain access to the nose and obtain a perfect view of the inside of the nose.
Left: Image of inferior nasal turbinates before the intervention (note the completely obstructed passage). Right: Image after the intervention showing no obstruction and increased space for breathing
Fig. 4: Preoperative image Fig. 5: Postoperative image
The image on the left clearly shows a significantly enlarged turbinate which leaves practically no space for breathing and causes obstruction. After the operation, there is plenty of space for breathing. This reduction is permanent as the turbinates will never grow back.
- There are many techniques for reducing the size of the turbinates, including radiofrequency treatment. In a case like this, however, in which the turbinates are significantly enlarged, the ideal treatment method for reducing the turbinates is using a laser.
- Let us now take a look at the image on the right (after the operation). There is plenty of space for breathing and, of course, the reduction is for life. These turbinates will never grow back.