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What Is The Permanent Solution For Enlarged Turbinate?

Posted on Thu, 26 Dec 2013

Question: Hi doctor, I have allergy to dust and detergent (and may be more that i have not discovered yet). I had consulted and ENT surgeon, and he said that both my 'inferior turbinates' are prominant and they are very sensitive. He performed a turbinate reduction surgery that lasted around 10 minutes. I was feeling alright for 10 months and the trouble started again. The turbinates grew again. This time it is getting more worse. I am looking for a permanent solution to this problem. Please help me find a good solution to this.

Answered by Dr. Prahlad Duggal (21 hours later)

Brief Answer: A coblation assisted redution and nasal sprays Detailed Answer: Hi, Thanks for your query. Turbinate hypertrophy is very common finding in allergic rhinitis. It is a result of recurrent swelling and regression of mucosal lining of inferior turbinates which leads to a sustained hypertrophy of that mucosa. A 10 minute procedure for reducing the volume must have been a cauterization of those turbinates or coblation assisted or laser assisted turbinoplasty. As the episodes of allergy keep on coming even after these procedures, the chances of recurrent hypertrophy are always there. Please use regularly an intranasal steroid spray and reduce the allergic episodes and this will reduce the chances of recurrent hypertrophy. Also if your previous procedure was a simple cauterization, a coblation assisted channelling of inferior turbinates give a better and more comfortable reduction in volume of turbinated. Please consult your doctor regarding this. Otherwise use of intranasal steroid spray helps in reducing the symptoms and is very safe and convenient. This minimizes the need for frequent reduction procedures. Feel free to ask another query. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prahlad Duggal (1 hour later)

Thank you for your reply. I need to do something very urgently. So I will follow up with my doctor as soon as possible. For the time being can I use intranasal steroid sprays ? Can I get the medicine without prescription ? If yes please advise one that is available in India. My current condition is really worse. If this gets more worse, I might start banging my head against the wall -- the irritation cause by my nose is that severe. And I sneeze so violently that I become very weak. So If possible please advise any nasal spray that soothes my nose.

Answered by Dr. Prahlad Duggal (1 hour later)

Brief Answer: Avamys, Flomist, Furamist are few brabd names Detailed Answer: Hi, Thanks for your query. Intranasal steroid sprays do not start action immediately after spray. For acute condition, use an anti allergic tablet like levocetrizine/cetirizine for 2 days along with spray and then stop the tablet and continue with spray. In India most of steroid nasal sprays are available without prescription. You can use any with Fluticosone as ingredient. Avamys, Flomist, Furamist are few commercial names. Please take stem inhalation and xylometazoline nasal drops for acute congestion but do not use xylometazoline nasal drops for continuous use for more than 5-6 days. Feel free to ask another query. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prahlad Duggal (8 minutes later)

I have tried Avamys, It works sometimes, but at times it does not give me any relief. Today I took 1 cetrizine tablet in the morning. I did not get any relief at all. Then I had to take another tablet in the afternoon. Even 2 tablets did not give me any results. and about 1 hour back I used avamys spray. Now one nostril is completely blocked and the other one is almost blocked. I feel a bit of breathing trouble. But the runny nose has stopped and all the irritation has stopped -- thats enough to keep me happy.

Answered by Dr. Prahlad Duggal (4 hours later)

Brief Answer: Steroid sprays are for long term use, monteleukast Detailed Answer: Thanks for your query. Steroid sprays are the drugs which are meant to be taken for longer durations to have optimum effect. A single or few days use is not going to keep your nose open. Long term regular use of these sprays lead to shrinkage of turbinate mucosa. These sprays are not meant for SOS use, A single tablet of 10 mg certizine should have the desired effect and taking it before meals ensures better absorption. Cetrizine is only going to block those allergic sings and symptoms which are mediated by histamine release but some of the allergic signs and symptoms are mediated by leukotrienes and needs to be blocked by Monteleukast. A combination of Levocetrizine with monteleukast will offer a better control of symptoms. Long term use of mast cell stabilizers also reduces the frequency of allergic episodes. Also do discuss with your doctor the option of trying immunotherapy as it is known to have beneficial effect in some patients. Feel free to ask another query. Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar