Allergic rhinitis and vasomotor rhintis causes the inferior turbinates inside the nasal cavity to be swollen causing nasal blockage.
The sinuses, which are hollow spaces in your facial bones, may also become blocked, leading to sinus infection.
There are 3 sets of turbinate bones in the nose. The inferior, middle and superior turbinates in each nostril, so total six. The inferior turbinates tend to be the ones that cause problems. Your turbinates are covered in a special lining called mucosa. They increase the surface area of your nose lining. This helps to warm and moisten the air you breathe in through your nose.
Medical treatment
Nasal steroid drops or sprays may relieve blockages caused by a swelling of the nasal lining. However, long-term use of nasal decongestant drops or sprays can eventually damage your nasal lining and make the blockage worse. Antihistamine and steroid tablets and injections can make the symptoms better but temporary.
If medical treatment fails, one can opt for a minor surgery like
1-Laser turbinectomy
2-Coblation Turbinoplasty
3- Partial turbinectomy
4- Submucous diathermy
Submucous diathermy
It is usually done under general anesthetic.
Sub mucous Diathermy (SMD) involves passing a probe just below the mucosal surface lining of the turbinate bones and cauterizing using heat energy (monopolar diathermy) to shrink the size of theses structures. This preserves most of the mucosal lining and allows for preservation of normal function.
Post operative bleeding is minimal and can be reduced by careful surgical techniques and the use of merocel®packing. Postoperative trauma and dryness can lead to bleeding and so the patient is instructed to keep the nose well moisturized with the use of a saline nasal douche.
Sicastat® (Feralcrylum) gel is a good haemostatic and moisturizer gel, which can be applied regularly or Vaseline can be applied to the anterior nostrils for symptomatic relief at bedtime and throughout the day as needed.
Avoidance of nose blowing and opening of the mouth with sneezing are very helpful. No heavy lifting or straining is Doing all of the above and staying well hydrated can minimize crusting.
I pass a spinal needle under the submocosa and touch the needle with cautery, this gives more precise diathermy and avoid too much burning of tissue unlike in using insulated diathermy needle. Bleeding is also very minimal.
