What are the turbinates/nasal concha and what function do they serve?

Turbinates are spongy bone structures on the sides of the inner nose that regulate airflow and protect the inner nasal anatomy. The general function of the turbinates is to control airflow. From the bottom to the top of the nose, there are three (sometimes four) sections of turbinate structures: the inferior, middle, and superior turbinates (the fourth, the supreme turbinate, is not present in every person).

Normal Inferior Turbinates

The inferior turbinate plays the largest part in directing airflow, but it also moistens, heats, and filters air coming into the respiratory system. The middle turbinate primarily protects the sinuses, while the superior turbinate primarily protects the olfactory bulb, which houses your smell receptors.

What can go wrong with the turbinates?

The primary issue people experience with their turbinates is turbinate hypertrophy (enlarged turbinates). Enlarged turbinates can be caused by allergies, chronic sinus inflammation, or environmental irritants. Turbinate hypertrophy can be situational or chronic. A common type of situational turbinate hypertrophy is the nasal cycle, in which the turbinates on one side of the nose will swell for four to six hours before returning to their normal size, at which point the turbinates on the other side will begin to swell.

Concha Bullosa (patient’s right nostril is blocked)

Concha bullosa is a condition unique to the middle turbinates where the middle turbinate is filled with air and enlarged like a balloon. When this happens, the concha bullosa blocks the flow of air to the sinuses via a small passageway called the sinus ostium. If the sinus ostium is blocked and air does not reach the sinuses, they can accumulate fluid and become infected.

How are turbinate hypertrophy and a deviated nasal septum related?

 

Enlarged Turbinates Caused by a Deviated Nasal Septum

 

A patient with a deviated nasal septum is more likely to have both turbinate hypertrophy and concha bullosa. Septal deviation causes turbinate hypertrophy because the structures within the nose tend to grow so that they fill open areas. If your septum is deviated to the left, that creates space for the right turbinate to grow larger.

How should I treat my enlarged turbinates?

Treatment options vary depending on the cause of your enlarged turbinates. Make sure you are certain of the cause before you begin treatment. If your enlarged turbinates are a result of allergies or environmental irritants, you can allergy-proof your home by following simple precautions to get rid of pollen, dust, and pet dander. The best long-term treatment for chronically enlarged turbinates – especially if caused by a deviated septum – is turbinate reduction surgery, which is often performed at the same as a septoplasty. Consult a board-certified ENT to determine the best course of treatment for you.