What's your experience with turbinectomy for dry nose and throat?

Posted by schnoz @schnoz, Jun 9 1:18pm

My ENT doctor recommends a bilateral inferior turbinectomy for me. I have never been able to breath through my nose very well and it's always dry. My mouth and throat are often dry too.

My real problem is being able to breathe well when I lie in bed. My nose and mouth become more dry and sometimes my throat gets congested. I sometimes wake up feeling kind of bad, like maybe I'm not getting enough air.

I have read comments by some who have problems after a turbinectomy. It makes me hesitant to have it done. My condition isn't horrible to live with. I read a comment by one person who recommended the Vivaer procedure as an alternative. Does anyone here have this type of problem or had surgery for it?

Interested in more discussions like this? Go to the Ear, Nose & Throat (ENT) group.

Hello @schnoz

As I see that this is just your second post since joining Connect, I would like to welcome you to the ENT discussion. As you are inquiring about both the Vivaer procedure and the turbinectomy, I wanted you to get acquainted with an existing discussion group about the Vivaer procedure. Here is the link to that discussion: https://connect.mayoclinic.org/discussion/vivaer-nasal-valve-remodeling-and-empty-nose-syndrome/. If you would like to ask questions of any of the members who have posted, just click on "Reply" and you can post your question or comment to them.

Connect has another discussion group that might be of interest to you that discusses nasal passages that are swollen. Here is the link to that discussion, https://connect.mayoclinic.org/discussion/nasal-passages-swollen-hard-to-breathe-through-nose/.

I found some information on WebMD regarding the Turbinectomy. Here is the link, https://www.webmd.com/a-to-z-guides/what-to-know-about-turbinectomy.

You do not mention in this post how long you have had difficulty breathing because of this nasal problem. Have you and your doctors discussed any other causes for the problem? I'm also wondering what other treatments you may have tried.

I hope you find some information that will help you make an informed decision on how to proceed. Will you post again and let me know how you are doing?

REPLY

@schnoz

Hopefully I can help-

There are about 100 reasons why your turbinates would swell. Learn about those first.

Also-your ENT is a surgeon. Remember that.
I recommend seeing a non surgical professional whom specializes in inflammation/immunology and can explain reasons for this mechanism of action.
A surgeons view is from what that can remove. Purely structural and nothing to do with why or how the body reacts systemically.

Also-any wider openings to the nasal cavity causes dryness. ENTs know this. The nasal cavity needs tight junctures for optimal humidification. I’d ask your ENT specifically how does widening the nasal cavity help with dryness specifically? See what their response is.

And do take note of your own quote “my condition is not horrible to live with”…

Better to spend time learning about how to work with your natural physiology than have it removed or altered.

Breathing and sensations within the nose are highly subjective. ENTs will try to match your subjective issues with an objective observation. No ENT can ever say you will breathe better after their recommended procedure. And any ENT whom claims that, I would steer very clear from.

A dry environment, stress, hypertension, allergies, non allergic rhinitis, hormonal changes, dehydration, diet and about 100 other things can cause a feeling of nasal obstruction. Also- dryness can give off the feeling of obstruction when really nothing is obstructed at all.

Your nose is an organ-remember that. Only time you would remove organ tissue is if it was cancerous or had abnormal growths.

REPLY
@hopeful33250

Hello @schnoz

As I see that this is just your second post since joining Connect, I would like to welcome you to the ENT discussion. As you are inquiring about both the Vivaer procedure and the turbinectomy, I wanted you to get acquainted with an existing discussion group about the Vivaer procedure. Here is the link to that discussion: https://connect.mayoclinic.org/discussion/vivaer-nasal-valve-remodeling-and-empty-nose-syndrome/. If you would like to ask questions of any of the members who have posted, just click on "Reply" and you can post your question or comment to them.

Connect has another discussion group that might be of interest to you that discusses nasal passages that are swollen. Here is the link to that discussion, https://connect.mayoclinic.org/discussion/nasal-passages-swollen-hard-to-breathe-through-nose/.

I found some information on WebMD regarding the Turbinectomy. Here is the link, https://www.webmd.com/a-to-z-guides/what-to-know-about-turbinectomy.

You do not mention in this post how long you have had difficulty breathing because of this nasal problem. Have you and your doctors discussed any other causes for the problem? I'm also wondering what other treatments you may have tried.

I hope you find some information that will help you make an informed decision on how to proceed. Will you post again and let me know how you are doing?

Jump to this post

Thank you for the information, Teresa.

I don't recall clearly how long this has been a problem for me but it's gotten worse in recent years. I think the surgeon I saw is an Otorhinolaryngologist. She had me try astelin nasal spray, mucinex and a neti pot. She also had me see another doctor to see if I was being affected by mold or allergies. After that, she recommended the turbinectomy. Previously, I saw an ENT who gave me several kinds of nose sprays and drops which only kept my nose moist for only a brief time, not throughout the night. He also had me try Medrol Dosepak, a steroid that prevents the release of substances in the body that cause inflammation.

REPLY
@nrd1

@schnoz

Hopefully I can help-

There are about 100 reasons why your turbinates would swell. Learn about those first.

Also-your ENT is a surgeon. Remember that.
I recommend seeing a non surgical professional whom specializes in inflammation/immunology and can explain reasons for this mechanism of action.
A surgeons view is from what that can remove. Purely structural and nothing to do with why or how the body reacts systemically.

Also-any wider openings to the nasal cavity causes dryness. ENTs know this. The nasal cavity needs tight junctures for optimal humidification. I’d ask your ENT specifically how does widening the nasal cavity help with dryness specifically? See what their response is.

And do take note of your own quote “my condition is not horrible to live with”…

Better to spend time learning about how to work with your natural physiology than have it removed or altered.

Breathing and sensations within the nose are highly subjective. ENTs will try to match your subjective issues with an objective observation. No ENT can ever say you will breathe better after their recommended procedure. And any ENT whom claims that, I would steer very clear from.

A dry environment, stress, hypertension, allergies, non allergic rhinitis, hormonal changes, dehydration, diet and about 100 other things can cause a feeling of nasal obstruction. Also- dryness can give off the feeling of obstruction when really nothing is obstructed at all.

Your nose is an organ-remember that. Only time you would remove organ tissue is if it was cancerous or had abnormal growths.

Jump to this post

Thank you, @seekinginfo. As I mentioned in my reply to Teresa I saw an ENT who gave me several kinds of nose sprays and drops which only kept my nose moist for only a brief time, not throughout the night. I think I will look for another non-surgical ENT who might have some additional ideas for me.

REPLY
@schnoz

Thank you, @seekinginfo. As I mentioned in my reply to Teresa I saw an ENT who gave me several kinds of nose sprays and drops which only kept my nose moist for only a brief time, not throughout the night. I think I will look for another non-surgical ENT who might have some additional ideas for me.

Jump to this post

@schnoz -you’re welcome

All ENTs are surgeons. The only time you should see an ENT is if you are looking for a structural change…

Other than that, your PCP or Allergist will give you same medications as an ENT.

Nasal Sprays (topical corticosteroids) would not help dryness-they address allergic responses.

Mucinex-thins mucous, so if you are not sick with a ton of mucous this would not work as well.

Medrol Dose Pack-(prednisone) would only work if you were having an inflammatory response.

These are only diagnostic tools-it does not in anyway mean “they didn’t work”. It means they were not addressing the original issue to begin with. But it all falls into the “tried and failed” maximum medical therapy bucket.

If it is truly a structural nasal valve breathing issue-I would see a facial plastic surgeon who is also trained in Otolaryngology.

If you are looking to feel more moisture, you’ve got to look from within.

Diet, Exercise, other medications, over all lifestyle.

Is anyone asking you those types of questions?

REPLY

I don't know if I have a structural nasal issue. Are you recommending I see a plastic surgeon to find out?

I saw two Otolaryngology surgeons. One recommended having my deviated septum fixed the other didn't think my septum was too bad. I think they both recommended a turbinectomy. I don't think they were plastic surgeons so I guess you don't think they were the best to diagnose me.

If it's not a structural issue and I need something for more moisture, what kind of a doctor do you suggest?

REPLY
@schnoz

I don't know if I have a structural nasal issue. Are you recommending I see a plastic surgeon to find out?

I saw two Otolaryngology surgeons. One recommended having my deviated septum fixed the other didn't think my septum was too bad. I think they both recommended a turbinectomy. I don't think they were plastic surgeons so I guess you don't think they were the best to diagnose me.

If it's not a structural issue and I need something for more moisture, what kind of a doctor do you suggest?

Jump to this post

@schnoz

My apologies if my reply was confusing. Let me clarify.

Every ENT is a trained surgeon.
They address structural issues.
So by the time you are referred to an ENT, they are expecting that you should be open to having your structure assessed and analyzed.

Many ENTs are double board certified in Facial Plastic Surgery as any involvement of the nasal/sinus cavity involves the face. Most people don’t think in this way but it is. So much better if ever opting for any surgery through an ENT to make sure they are double board certified.

80% of people have a deviated septum. Most would never know unless they had someone put a scope in their nose or request a CT.

One recommended your deviated septum fixed -that’s structural.

Both recommended turbinectomy- that’s structural.

They are recommended you remove cartilage and delicate tissue off of your nasal structure. Hence structural.

Both recommended turbincetomy most likely because it is the easiest procedure. But there are many questions that come with this.
That must be asked of them. Both most likely use their own technique and tools that they are the most experienced in.
Different techniques cause more harm than others.

I will reiterate-there are a ton of other reasons why nasal tissue congests . Even acid reflux can back up into the nasal pharynx while sleeping and cause nasal tissue to swell.

Anyone ever mention Vitamin & Nutrients?
Vit A deficiency is known to cause dry nasal passages as well as Vit D.

Life style- are you constantly exposed to a dry environment?

Do you exercise regularly?

Do you avoid eating before bed?

Have you eliminated certain foods to see?

There is actually a new book out called:
Breath-The Science of a Lost Art

It’s helpful to understand how everything is connected and truly works together.

REPLY

The first ENT I saw never suggested surgery. I didn't think he did surgery.

What questions should I ask the surgeons about the turbinectomy? The specifics of how they perform it? I thought you felt that turbinectomies were not a good idea.

What kind of doctor can help diagnose my problem other than a ENT?

I don't know if you wanted me to answer your questions but:
I'm not in a dry environment. I am underweight. I can't gain much weight because my stomach feels overstuffed if I try to increase calories. Sometimes I get burning or discomfort in my stomach. I've seen a number of GI doctors and dieticians.
Many foods and drinks don't agree with me. I exercise. I don't eat before bed.

REPLY
@schnoz

The first ENT I saw never suggested surgery. I didn't think he did surgery.

What questions should I ask the surgeons about the turbinectomy? The specifics of how they perform it? I thought you felt that turbinectomies were not a good idea.

What kind of doctor can help diagnose my problem other than a ENT?

I don't know if you wanted me to answer your questions but:
I'm not in a dry environment. I am underweight. I can't gain much weight because my stomach feels overstuffed if I try to increase calories. Sometimes I get burning or discomfort in my stomach. I've seen a number of GI doctors and dieticians.
Many foods and drinks don't agree with me. I exercise. I don't eat before bed.

Jump to this post

Hello again, @schnoz

I see that you have had a lot of replies to your post. I also see in your last post that you mention being underweight and that your stomach feels overly full.

As you have said that you have been seen by GI specialists, would you mind sharing what type of tests they did and any conclusions they might have made?

Since there are a number of foods that bother you, have you considered keeping a daily journal of food, beverages, and physical activity to see if there is any correlation between those and your symptoms?

I can see that this is more complicated than just the nasal problem. Have you been referred to any other specialists for a review of your symptoms?

Endocrinologists are quite good at putting together symptoms and seeing the "big picture" if you will.

I look forward to hearing from you again. Finding answers to complex problems is a process. Will you continue to post updates as you progress through this process of finding answers?

REPLY
@nrd1

@schnoz

Hopefully I can help-

There are about 100 reasons why your turbinates would swell. Learn about those first.

Also-your ENT is a surgeon. Remember that.
I recommend seeing a non surgical professional whom specializes in inflammation/immunology and can explain reasons for this mechanism of action.
A surgeons view is from what that can remove. Purely structural and nothing to do with why or how the body reacts systemically.

Also-any wider openings to the nasal cavity causes dryness. ENTs know this. The nasal cavity needs tight junctures for optimal humidification. I’d ask your ENT specifically how does widening the nasal cavity help with dryness specifically? See what their response is.

And do take note of your own quote “my condition is not horrible to live with”…

Better to spend time learning about how to work with your natural physiology than have it removed or altered.

Breathing and sensations within the nose are highly subjective. ENTs will try to match your subjective issues with an objective observation. No ENT can ever say you will breathe better after their recommended procedure. And any ENT whom claims that, I would steer very clear from.

A dry environment, stress, hypertension, allergies, non allergic rhinitis, hormonal changes, dehydration, diet and about 100 other things can cause a feeling of nasal obstruction. Also- dryness can give off the feeling of obstruction when really nothing is obstructed at all.

Your nose is an organ-remember that. Only time you would remove organ tissue is if it was cancerous or had abnormal growths.

Jump to this post

"(A)ny wider openings to the nasal cavity causes dryness". I disagree with that statement @nrd1
I have suffered with dryness sensations in my nose and mouth when I sleep for decades. I also have suffered with dryness sensations during the day. I have had the Vivaer procedure recommended for me recently. Does anyone out there have actual experience with this procedure? Please relate the pros and cons you experienced.

Also, "Your nose is an organ-remember that. Only time you would remove organ tissue is if it was cancerous or had abnormal growths." I don't agree with that statement either. If your organ is blocking you breathing passage, it may be okay to remove some of it.

REPLY
@hopeful33250

Hello again, @schnoz

I see that you have had a lot of replies to your post. I also see in your last post that you mention being underweight and that your stomach feels overly full.

As you have said that you have been seen by GI specialists, would you mind sharing what type of tests they did and any conclusions they might have made?

Since there are a number of foods that bother you, have you considered keeping a daily journal of food, beverages, and physical activity to see if there is any correlation between those and your symptoms?

I can see that this is more complicated than just the nasal problem. Have you been referred to any other specialists for a review of your symptoms?

Endocrinologists are quite good at putting together symptoms and seeing the "big picture" if you will.

I look forward to hearing from you again. Finding answers to complex problems is a process. Will you continue to post updates as you progress through this process of finding answers?

Jump to this post

Hi Teresa,

No one has ever told me that my digestion issues are related to my dry nose and mouth.

I have seen a number of GI doctors and dieticians though. I guess they might say I have something like Gastroesophageal reflux disease although I don't think my symptoms are exactly what would typically be considered GERD.

REPLY
@schnoz

The first ENT I saw never suggested surgery. I didn't think he did surgery.

What questions should I ask the surgeons about the turbinectomy? The specifics of how they perform it? I thought you felt that turbinectomies were not a good idea.

What kind of doctor can help diagnose my problem other than a ENT?

I don't know if you wanted me to answer your questions but:
I'm not in a dry environment. I am underweight. I can't gain much weight because my stomach feels overstuffed if I try to increase calories. Sometimes I get burning or discomfort in my stomach. I've seen a number of GI doctors and dieticians.
Many foods and drinks don't agree with me. I exercise. I don't eat before bed.

Jump to this post

@schnoz

I tend to ask questions because the human body is complex and works entirely as a whole system.

Often when I ask questions it will lead to another issue or issues the person mentions. Specialists do not work in this way.

For example-many people who visit an ENT for “throat” issues will be diagnosed with silent reflux and referred to a GI specialist. That person had only ever felt soreness in their throat, however it is coming from their stomach. That reflux can back up into their nasal pharynx and turbinates causing swelling and congestion.

-When people get congestion from drinking milk or any dairy products. That comes directly from the gut interaction of the inflammatory response to dairy in your system. The nose doesn’t congest because you are putting milk directly on your nasal tissue. It is coming from the response, systemically, internally.
When some people remove dairy from their diet, they notice their eyes clear up and they can breathe better. That has nothing to do anything being removed from the eyes or nose. That is the response of removing the inflammatory load on the entire system.

These are ONLY examples-may or may not be your situation. These are examples to show you how the nasal tissues respond to everything systemically as well as externally.

If you have seen a number of specialists-GI and Nutritionists I am curious on what their advice was to you? Ok so they say you “have” GERD. Do they tell you what causes GERD or send you on your way with an RX for Prilosec, without any other recommendations?

And to answer your original question of this thread.

Correct- I personally don’t agree with turbinectomies, and you can find many medical doctors who don’t as well.
What anyone needs to remember is even surgeries, evolve with more research over time,that proves what once what thought to be acceptable is not.

REPLY
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