Nasal Concha Enlargement (Concha Hypertrophy)
The nasal flesh, medically called the concha, is the usual anatomical formations, which are 3 in each nasal cavity. Their mission is to humidify, warm and clean the air entering the nose. It consists of bone and soft tissue. The soft tissue part is rich in heavy blood vessels and glands.
The enlargement of the nasal concha, called turbinate hypertrophy, develops due to swelling in the soft tissue forming the turbinate or the structural size of the bone tissue. The most common cause of turbinate hypertrophy is allergies. However, other factors causing sinusitis and rhinitis cause turbinate hypertrophy.
The most common symptoms are nasal congestion, mouth breathing and snoring.
The treatment is primarily the elimination of the underlying cause and nasal sprays. Different surgical procedures are applied in cases resistant to drug therapy. For the effectiveness of the surgery to be performed, first of all, it is necessary to make a true distinction whether the turbinate hypertrophy is due to bone growth or soft tissue swelling. Surgery can be performed under local or general anesthesia. The process takes about 15-30 minutes, and at the end of the process, it does not cause any discomfort in the patient, except for the temporary nasal congestion that develops due to edema.
Types of surgical processes
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Resection: Removal of soft tissue or bone tissue by cutting
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Lateralization: The process of widening the air passage by breaking the concha bone outward.
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Electrocauterization: The process of reducing soft tissue by heating with bipolar cautery
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Radiofrequency: Reduction by creating a heat-controlled thermal lesion in soft tissue with low-power electromagnetic radiofrequency waves
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Coblation: The process of creating controlled tissue damage by creating an ionic plasma field with less heat
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Debrider: The process of preserving and shaving the soft tissue of the turbinate and the mucosal cover on the bone tissue.
Curvature of Nasal Cartilage and Bone (Septum Deviation)
The structure consisting of bone and cartilage that divides the nasal cavity into 2 equal parts is called the septum. If there is a curvature in the septum cartilage; Nasal congestion occurs due to the decrease of air passing through the nostril on that side. The degree of curvature, its side and its connection with the sinus mouth affect the complaint of nasal congestion. This curvature can develop due to genetic, congenital or childhood traumas.
Nasal congestion causes open mouth breathing and snoring, which greatly impairs the quality of life. It is also a risk factor for sinusitis and nosebleeds.
For the diagnosis of septum deviation, primarily nasal examination, examination of the nasal cavities with a camera and computed tomography radiologically are used.
The treatment of septum deviation is surgery. There is no drug treatment. It is the process of correcting curved cartilage and bone structures by making an incision through the nose with surgery. The process takes between 1-2 hours. Post-operative recovery takes about 3 weeks.
Sinusitis
Sinuses are air spaces within the facial bones. These air spaces are opened to the nasal cavity with special channels. The air entering the nostrils reaches the sinuses through these channels. There are four on each side in the form of cheek (maxillary), forehead (frontal), periocular (ethmoid) and posterior eye (sphenoid) sinuses. Their mission is to reduce the weight of the skull, to prevent the blow to the face from reaching the brain, to moisten and warm the air entering the nose.
Sinusitis is an infection that occurs in the sinus due to the obstruction of the channels of these air-filled spaces. According to the time of infection, it is divided into acute and chronic sinusitis. Infections that last longer than 3 months are called chronic sinusitis. There are 2 subtypes of chronic sinusitis, with and without polyps. Sinus polyps, also known as nasal polyps, are edematous pale-colored new formations in the nasal cavity and sinus in addition to chronic sinusitis complaints. Recurrent sinusitis is defined as having more than 4 acute sinusitis attacks in 1 year.
The diagnosis of sinusitis is made by the patient’s complaints, time and detailed endoscopic nasal examination. There should be at least one of the complaints of nasal congestion or discharge (frontal or nasal). Along with these, localized pressure and pain on the face, difficulty in smelling and coughing (in children) may accompany the complaints. In addition to the complaints, the presence of edema, obstruction, inflammation or polyp in the sinus openings supports the diagnosis.
The common cold is actually a form of sinusitis. Virus-induced sinusitis lasting less than 10 days is called a cold. Bacterial sinusitis, on the other hand, generally occurs for longer than 7-10 days or when the complaints worsen within this period.
The common cold is the condition in which the infection does not affect the sinuses and is only in the nasal cavity. Colds can be caused by viruses, allergies, medications, hormones, or non-infectious causes.
Sinusitis is a disease that should be treated and followed in order to prevent it from becoming chronic and to prevent the spread of the infection, which we define as a complication, to the eye and brain.
Treatments used according to the type and severity of the disease:
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antibiotics
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Nasal sprays (steroid and decongestant sprays)
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Antihistamine drugs
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pain relievers
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nasal wash solutions
Another alternative in the treatment of sinusitis is endoscopic sinus surgery. The surgery is performed with a camera called an endoscope without making an incision. The purpose of the surgery is to open the mouth of the clogged sinus canals and to clean the inflamed tissues inside.
Surgical conditions
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Acute sinusitis with complications
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Chronic sinusitis resistant to maximal drug therapy
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Chronic sinusitis with refractory polyps
