Enlarged turbinates

[Sylvanas]

I was diagnosed with UARS and advised to trial CPAP. Part of my problem is having enlarged turbinates (structures inside the nose). When laying down, one of my nostrils is usually completely blocked. Would CPAP still work with the nose half blocked?
I saw an ENT for this issue long time ago and he advised turbinate reduction, but I'm terrified of surgery. Anyone had luck reducing their turbinates without surgical intervention? I tried steroid spray for couple of weeks with no result.

[Julie]

Lots of people have turbinate surgery without problems, and while it won't cure apnea (which is a reduced airway problem) it could help you breathe easier. It's a really common and usually trouble free procedure - just let them know you have apnea and to monitor your 02 in Recovery.

But have you tried e.g. Flonase to help (not Afrin - you don't want that).

[Sylvanas]

Lots of people have turbinate surgery without problems, and while it won't cure apnea (which is a reduced airway problem) it could help you breathe easier. It's a really common and usually trouble free procedure - just let them know you have apnea and to monitor your 02 in Recovery.

But have you tried e.g. Flonase to help (not Afrin - you don't want that).

I tried Avamys (sp?), which is similar to Flonase.
I'd really really like to avoid surgery, there are plenty of things that can go wrong, even now.

[Julie]

Well I think asking about other ways to reduce turbinates is something for your doctor... but I imagine if there were other ways, he/she would have told you about them by now.

[weiss27md]

I had swollen nasal passages too. Surgery was decided because I had a sinus infection that would not go away with antibiotics. I ended up getting turbinate reduction, balloon sinuplasty and septoplasty. Nasal pillow or a nasal mask might open up your nasal passages more. I have used P10s and N20s. I was on PAP therapy for a month or two and gave up. At home sleep studies showed AHI of 5.5 and 8.3 and don't think they checked for RERAs. Not sure if I have UARS or RERAs but my sleep is terrible. PAP therapy lowered AHI to 1-3 a night with just CAs left but no improvement in fatigue. I see a functional medicine doctor on Thursday. I've been to several doctors, sleep doctors and immunologists with no improvement in my sleep. They don't care how tired I am, they just see a low AHI and dismiss me. Cut out caffeine for a couple weeks with no improvement, maybe it takes months? I think dairy might be causing restriction in my nose even though I don't think there were any flow limits in my OSCAR data. I don't know anymore. I know it is sleep related though.

[weiss27md]

Try to cut out things people might be allergic to like: dairy, gluten, eggs, nuts, etc. My nose feels fine now but I don't know what to compare it to. It's not almost completely shut like it used to be. I'm not allergic to anything in the air. Skin allergy test came back negative. My symptoms are year round plus I bought an Austin Air air purifier with no improvement in symptoms. I would do nasal rinses every night which felt good but no improvement in swelling. Allergy medicine did nothing for me either. I know it's food or gut related. I was diagnosed with GERD 15 years ago. Pretty sure I have a leaky gut so I react to almost all foods. I am starting to get RA so I have joint pain in my hands. There was no pain with surgery, did not even have to use pain meds afterwards. Just went under and woke up with a bloody nose. Blood steadily but slowly pours out for 12-24 hours. Bloody nose last for about 2-3 days. Nasal rinses had blood clots coming out for like 2 weeks. Nose was totally blocked for 3 days so had to breathe out of mouth. Would I do it again? IDK, no improvement in sleep but can breathe better out of my nose. I would do the other things first though. Cut out wheat, gluten, dairy, eggs, sugar, alcohol and nightshades for 30 days if you really want to see.

[Julie]

Weiss - have you not been tested for what you might be allergic to? I would think that would be a good idea considering.

[weiss27md]

I've had a full skin allergy test which test for environmental allergies, plus 20 on the arm, all negative. I have not had any food allergy testing. I'm technically not allergic to any foods since no foods give me a major allergic reaction. I guess it's more like a sensitivity or intolerance. For food sensitivities there is the MRT (Mediator Release Test) MRT and different Immunoglobulins tests. I'll see what my doctors says on Thursday, see if he thinks I need a food allergy test and if so, which one is the most reliable. The cheapest way is to just do an elimination diet. Basically eat just beef, water and salt for 30 days, nothing else. Then add a food item once a week to look for reactions. For food sensitivities reactions are usually not immediate so they are hard to keep track of unless you do an elimination diet.

[Cokomo]

I had turbinate reduction twice in the last 10 years . The first time was a huge game changer for my cpap therapy . Double digit ahi went to < 1 in about 2 weeks after surgery . The second surgery about 5 years later, was as a result of turbinates growing back . Ahi was creeping towards 2-3 and the surgery brought me back to < 1 consistently to this day .

[TheDuke]

I had turbinate reduction with a local ENT quite a number of years ago. It was an in-office procedure and I think I had some sort of medication to calm me, but I was not anesthesized, and I drove myself home maybe an hour later. It really wasn't bad at all.

TheDuke

[ChicagoGranny]

When laying down, one of my nostrils is usually completely blocked.

Which position are you lying in?

[ChicagoGranny]

I had turbinate reduction with a local ENT quite a number of years ago. It was an in-office procedure and I think I had some sort of medication to calm me, but I was not anesthesized, and I drove myself home maybe an hour later. It really wasn't bad at all.

TheDuke

You must have had radio-frequency ablation. Surgical resectioning of the turbinates requires general anesthesia and someone to drive you home. Gramps had surgical resectioning and straightening of the septum. Virtually painless, and he recovered quickly.

[tarheelalum]

I also have enlarged turbinates and have really bad flow limitations with my cpap. I was told I need the turbinate reduction and my septum repaired by an ENT a while ago but then the virus mess started and everything shut down. I read up on the surgery and heard about the off chance of getting empty nose syndrome so I kind of put it all off. I told my regular doctor about situation and he said to get a second opinion. So this morning I went to see another ENT and he told me my septum wasn't that bad but my turbinates were enlarged and also the side walls of my nose were collapsing when I breathed in my nose. He said he could fix the collapsing walls and the turbinates without surgery with a much lower risk of getting the empty nose syndrome. He said it was called a VivAer procedure. I have not read up on it much yet. That is actually why I came to the forum today to see if anyone else had the procedure before. But I think I'm going to do the procedure in a few months from now. He said I had to be awake for the procedure in his office but I don't like that very much. I'd much rather be knocked out honesty. But the doctor said he would give me valium and it would only take about 30 minutes. He said I would be fully recovered in about a week.

[ChicagoGranny]

empty nose syndrome

This is a very bad condition that was the result of surgeries done a couple of decades ago. It would be a rare and very bad ENT who is not fully aware of the side effect these days. ENTs take care not to surgically remove as much turbinate as some did in the early days of the surgery.

VivAer procedure

Weak or inward-bent cartilage of the nasal sidewall at the level of the internal nasal valve can produce narrowness or collapse of the nasal valve. The VivAer procedure uses radio-frequency ablation to remold this area. If the turbinates are indeed permanently enlarged, the VivAer procedure is unlikely to produce good results.

Do your research. Make sure your nasal evaluation lends itself to good results from a VivAer procedure. Some ENTs are infatuated with the procedure. Find one that will give an unbiased opinion.

Try the Cottle maneuver on your own - https://aerinmedical.com/for-patients/v ... treatment/

[tarheelalum]

empty nose syndrome

This is a very bad condition that was the result of surgeries done a couple of decades ago. It would be a rare and very bad ENT who is not fully aware of the side effect these days. ENTs take care not to surgically remove as much turbinate as some did in the early days of the surgery.

VivAer procedure

Weak or inward-bent cartilage of the nasal sidewall at the level of the internal nasal valve can produce narrowness or collapse of the nasal valve. The VivAer procedure uses radio-frequency ablation to remold this area. If the turbinates are indeed permanently enlarged, the VivAer procedure is unlikely to produce good results.

Do your research. Make sure your nasal evaluation lends itself to good results from a VivAer procedure. Some ENTs are infatuated with the procedure. Find one that will give an unbiased opinion.

Try the Cottle maneuver on your own - https://aerinmedical.com/for-patients/v ... treatment/

Yes the Cottle maneuver really does allow me to breath better. It is a dramatic improvement. Do you know many people who have had this procedure? Were they pleased with the results?