While surgery does not cure allergic or non-allergic rhinitis, it can dramatically improve the symptoms. Surgery is usually performed to open the nasal passages and improve breathing. These surgeries focus on reducing the size of the turbinates, which leads to a larger airway. A septoplasty or straitening of the septum (the septum is the middle part of the nose) can also improve nasal breathing if the septum is crooked or deviated. Surgery to reduce the turbinates may be done in the operating room or in the office.

Septoplasty

Septoplasty involves the straitening of the septum. The septum is the central part of the nose which devides the right and left nasal cavities. If the septum is crooked or deviated, it will partially block one or both nasal cavities. The septum may be deviated to one side or may be S shaped and curve into both nasal cavities.

The septoplasty operation is performed in the operating room, through the nostrils. Typically after surgery there is no bruising, cast on the nose or need for nasal packing. The surgery is performed with small instruments through the nostrils and in most cases, the incisions are all internal. Most patients are able to return to school or work after just a few days and return to normal activity in a few weeks.

Turbinate reduction

The nasal turbinates are structures within the nose which moisturize and warm the air as you breath. There are three turbinates on each side of the nose (a lower, middle and upper turbinate). As the air flows past the turbinates, the air is warmed up and humidified so that once the air gets to the lungs, it is more comfortable. However, if the turbinates enlarge due to a deviated septum, allergic rhinitis, non-allergic rhinitis or sinus infections, they may block the nose and cause difficulty breathing. If the turbinates are too large, we will usually reduce the lower or middle ones.

The size of the turbinates may be reduced in the operating room by trimming part of the surface lining or the underlying boney structure. Sometimes the lining is too bulky and other times the bone is too large and sometimes both may be contributing to the problem. An operation called submucous resection of the turbinates achieves a reduction of both soft tissue and boney portions of the turbinates. This surgery caused minimal discomfort. Most patients are able to return to school or work after just a few days and return to normal activity in a few weeks.

Somnoplasty (Radiofrequency treatment) of the turbinate

When just the soft tissue lining of the turbinates is enlarged, radiofrequency treatment (also known as Somnoplasty or Coblation) of the turbinate can be performed. This procedure can be done in the office or the operating room. The turbinate is numbed up and a needle probe is inserted just under the surface of the turbinate. A generator delivers radiofrequency energy (like microwave energy) to the turbinate, causing some scarring under the surface and leading to a shrinkage of the turbinate. After the procedure, the patient usually applies some saline spray for a few weeks to help speed healing. Most patients are able to return to school or work and normal activity the next day.