What are the controversies related to turbinate dysfunction treatment?

Answer

As with any medical condition, advances in the understanding of both allergic and vasomotor rhinitis will lead to better medical therapies. Surgical therapy will continue to be reserved for patients whose conditions are refractory to medical therapy. The relationship between turbinate hypertrophy and sleep-disordered breathing problems is also currently under investigation.

The major controversies surrounding turbinate surgery continue to be centered on the best techniques for management. Avoidance of overly aggressive therapies and control of the underlying disease states are paramount to disease management. The toughest issue to reconcile is that turbinate dysfunction is a quality of life issue. Management of this problem is not mandatory but very helpful for patients' quality of life.

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Media Gallery

Normal-sized right inferior turbinate with a moderate inferior septal deflection.
Bony hypertrophy of the right inferior turbinate following topical vasoconstriction.
Mucosal hypertrophy of the right inferior turbinate with total airway obstruction.
Mucosal hypertrophy of the left inferior turbinate with impingement of the septum and narrowed nasal airway.
A stab incision is made at the anterior head of the inferior turbinate. Blunt dissection beneath the mucoperiosteum elevates tissue for subsequent microdebridement. The microdebrider is turned in all directions, but mucosa is entirely preserved. Video courtesy of Vijay R Ramakrishnan, MD.

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Author

Sanford M Archer, MD, FACS Professor of Surgery and Pediatrics, Medical Director, UK Voice and Swallowing Clinic, Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Chandler Medical Center

Sanford M Archer, MD, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Head and Neck Society, American Rhinologic Society, Kentucky Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Dominique Dorion, MD, MSc, FRCSC, FACS Dean, Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Université de Sherbrooke, Canada

Dominique Dorion, MD, MSc, FRCSC, FACS is a member of the following medical societies: Canadian Society of Otolaryngology-Head & Neck Surgery

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;Cliexa, eMedevents, Neosoma, MI10<br/>Received income in an amount equal to or greater than $250 from: , Cliexa;;Neosoma<br/> Received stock from RxRevu; Received ownership interest from Cerescan for consulting; for: Neosoma, eMedevents, MI10.

Acknowledgements

Gregory Branham, MD Vice-Chair, Director, Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, St Louis University School of Medicine

Gregory Branham, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, and Missouri State Medical Association

Disclosure: Nothing to disclose.

Acknowledgments

Medscape Drugs and Diseases thanks Vijay R Ramakrishnan, MD, Assistant Professor, Department of Otolaryngology, University of Colorado School of Medicine, for assistance with the video contribution to this article.

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