Which Patients With Nasal Hperventilation May Benefit From Turbinate Filler Injection!

Turbinate Enlargement - Augmentation With HA Filler in Patient With Empty Nose Syndrome / Nasal Hyperventilation

Tissues called turbinate in the nasal cavity, by narrowing the air passage of the nasal cavity, enable the air to make a rotational movement in the nose; They also ensure that this air is heated, humidified, pressurized and purified. Especially inferior turbinates are responsible for most of these tasks.

Turbinates Should Be Accepted as "Organ"

All tissues in the nose are unique and the excision of these tissues completely or partially is an "organ loss" due to the fact that these tissues cannot be replaced or formed from a new one. Turbinates can grow due to allergy, pollution, and various environmental-genetic reasons. This condition is called "turbinate hypertrophy". In this case, most physicians primarily recommend medical treatment and local treatment applications. When sufficient volume reduction cannot be achieved with this treatment, applications such as radiofrequency, coblation and laser can be planned to reduce the volume of turbinates. In addition to these, serious volume reduction surgical procedures such as turbinoplasty or turbinectomy can also be performed. Things to consider in reducing the volume of turbinates can be listed as follows:

- Protecting the turbinate mucosa as much as possible and performing the procedure in such a way that heat damage to the mucosa is minimal. For this, there are modern radiofrequency devices that automatically measure tissue resistance.
- The turbinates are not heated as much as possible and the blood vessel circulation in them is least damaged. In addition to excessive shrinkage in the turbinate tissue, where too much laser or radiofrequency energy is given, the presence of intense fibrosis seriously damages the air heating capacity of these tissues.
- making only a volume reduction process as much as possible and preserving the turbinate structure. Like turbinectomy, removal of this tissue in the form of excision causes serious volume and function loss.

What Does Nasal Hyperventilation Mean?

This is the occurrence of symptoms such as abnormal acceleration of the air flow entering it, drying in the nose, crusting, and a feeling of dryness in the nasal area. The more the turbinate volume is reduced, the greater the airflow rate and associated symptoms.

What is Empty Nose Syndrome?

In fact, a further advance of nasal hyperventilation, which is characterized by an abnormal increase in intranasal air flow and severe reduction in nasal functions, occurs as a result of surgical removal or overreduction of the turbinates in the nose. You can find it in the links below and at the link ENSAssociation.org - ENS Association - https://www.facebook.com/ENSIAssociation/.

In patients where turbinates are almost completely removed, severe symptoms such as pain, drying, crusting, air hunger or suffocation may occur in the nose. It is inevitable that the moisturizing capacity of the nose will disappear because the air passing through the nose has a very fast flow rate. You can watch a video of a patient named "The Invisible Pain of Empty Nose Syndrome" below.

In Which Patients Can Turbinate Filler Injection Be Beneficial?

In patients in whom the volume of turbinates is reduced partially or has been resected in a small amount, an increase in intranasal airway resistance can be achieved, especially by injection of cross-linked hyaluronic acid fillers to the anterior part of the turbinates and the anterior part of the nasal septum. In this way, a serious reduction in the air flow rate through the nose can be achieved. In patients who have previously undergone turbinate reduction and an abnormal increase in air flow rate in the nose, an increase in turbinate volumes and a decrease in patient complaints with such an application may guide the surgical procedures that can be planned to narrow the nasal airway.

In Which Patients Turbinate Filler Injection Is Not Appropriate (It Will Not Beneficial)

Especially in patients with almost complete turbinate excision, a serious airway narrowing cannot be achieved with a few ml of filler injection. Since some patients have nearly total turbinate excretion, it would not be reasonable to expect a serious benefit from the filler injection.

Below you can find detailed information on the subject.

I have previously published a detailed article on  and hyaluronic acid gel injection to in patients with empty nose syndrome >>Hyaluronic Acid Gel Injection To The Inferior Turbinate For The Treatment Of Empty Nose Syndrome

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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