Inferior Turbinate Hypertrophy 下鼻甲肥大
Inferior Turbinate Hypertrophy 下鼻甲肥大
When you look in the mirror, you can see a round pink soft tissue in the nasal cavity, and it is the inferior turbinate. Due to long-term stimulation and inflammation, the mucosa of the inferior turbinate is becoming more and more hypertrophic, causing nasal congestion and hypertrophic rhinitis.
Most of nasal congestion is a result of the abnormal nasal structure, with the common symptom of inferior turbinate hypertrophy combined with nasal septum deviation (NSD). Inferior turbinate hypertrophy is the most common cause of nasal obstruction. Patients often have alternating nasal obstruction on both sides. NSD is another cause of nasal congestion.
The nasal septum is the partition between two nasal cavities, with the cartilage in the front and bone in the back. In fact, everyone has NSD more or less, which is due to the inconsistency between the growth rate of nasal septum cartilage and that of the nasal cavity in the course of development. In rare cases, the nasal septum may be bent due to severe trauma. Once the septum is crooked, in addition to the protruding side, the concave side is also prone to hypertrophy of the inferior turbinate, resulting in the obstruction of both sides. This is why inferior turbinate hypertrophy and NSD should be treated together during surgery.
Long-term hypertrophy of the inferior turbinate will damage the normal expansion and contraction of the inferior turbinate, resulting in persistent nasal obstruction, nasal irritation, and recurrent runny nose.
Inferior turbinate hypertrophy is caused by congenital hypertrophy of inferior turbinate bone, or acquired inflammation and swelling of inferior turbinate mucosa, such as allergic rhinitis and vasomotor rhinitis.
As people often mistake the inferior turbinate for nasal polyps, patients confuse the former with the latter. Nasal polyps refer to the abnormal soft tissue growing from the sinus to the nasal cavity, like water balloons, with pale or gray color, which is quite different from the inferior turbinate, but are seldom found in most people. Nasal polyps are mostly associated with sinusitis, or allergic rhinitis.
- Hypertrophic mucosa: Drug therapy is usually given first for the cause of the disease
- Inferior turbinate hypertrophy caused by allergic rhinitis: With oral medicine as the main treatment, nasal sprays are currently divided into three categories: nasal mucosal contractile sprays, steroid sprays, and antihistamine sprays. The nasal mucosal contractile spray can be easily purchased in the pharmacy. It has the upper limit of use, not more than five days as the principle and can only be used in an emergency. For long-term use, it will cause serious congestion and swelling of the inferior turbinate mucosa, which is called rhinitis medicamentosa in medicine, resulting in serious consequences that the symptom cannot be treated with medication anymore. As a result, steroid sprays and antihistamine sprays are safer than nasal mucosal contractile sprays.
- Unlike oral or injectable steroids, inhaled steroids enter the bloodstream in small amounts and do not affect other organs. Currently, it is generally safe for patients over the age of 4, but pregnant women should avoid them as much as possible. Steroid sprays must be used without interruption in order to be effective. Short-term use of steroid sprays is generally ineffective.
- Allergic rhinitis patients are generally advised to use it for at least three months.
- If steroid sprays are found ineffective following more than three months of application or recurrent symptoms are experienced, surgery may be considered as an adjunct treatment. Operations include bipolar electrocautery, laser, or radiofrequency surgery.
- Inferior turbinate hypertrophy caused by bone hypertrophy: Drugs are ineffective. Only partial resection of the inferior turbinate can be performed, that is, partial removal of the inferior turbinate by conchotomy scissors. Sometimes according to the disease, a surgical procedure is required to correct a deviated septum.
- In addition to nasal congestion, patients with severe NSD are also prone to injury on the protruding side, sometimes with recurrent nosebleeds. NSD can only be corrected by a surgical procedure, with drugs or laser being of no avail. Common operations include submucosal resection of nasal septum and septoplasty.
Anecdotal evidence suggests that nasal polyps are to blame for all nasal congestion. In fact, according to clinical experience and statistics, only a very small number of patients with nasal congestion are caused by nasal polyps. Next time a doctor tells you that you have a nasal polyp, be sure to confirm whether it is really a nasal polyp or hypertrophy of the inferior turbinate. You may consult a second otolaryngologist. In case it's a nasal polyp, the treatment is totally different from the above.
The following is the correct use of nasal sprays. Regardless of the nasal mucosal contractile spray and steroid spray, the use method is roughly the same:
- Before use, shake the spray first and blow your nose clean. Put the nozzle into the nostril gently while keeping it upright, and press the nozzle after temporarily holding your breath, so that the liquid can permeate the nasal cavity, and then press the nostril on the side for several seconds, so that the liquid is not sucked in.
- After breathing through your mouth, turn to the other side and repeat the procedure.
- Clean the nozzle after use (wipe it with toilet paper) to avoid contamination, and then put the cap back to complete the whole procedure.
Please keep the spray in a dry and cool place and out of reach of children. There is no need to put it in the refrigerator. For adults, nasal mucosal contractile sprays are for short-term use only, 1-3 times a day, one spray to the two nasal cavities each time, with an upper limit of 5 days. On the other hand, steroid sprays are applied to the nostrils once a day, with two sprays each time or twice a day with one spray per time. Antihistamines nasal sprays (e.g. Azetin) are applied to each nostril one to two times per day, with one spray each time for adults and children older than 5 years old. You are advised to read the instructions carefully before use or consult the medical staff.