Turbinate hypertrophy is when the nasal turbinates (structures inside the nose) become enlarged. These structures help filter the air you breathe and also warm and humidify the air before it reaches the lungs.
When the turbinates swell, they can block airflow and cause nasal congestion. This may lead to symptoms like dry mouth, a runny nose, or snoring.
Enlarged turbinates can happen due to changes in the nasal anatomy, allergic rhinitis, chronic sinusitis, or frequent exposure to irritants like cigarette smoke. Treatment is guided by an otolaryngologist (ENT specialist) and may include medications or surgery to improve airflow, depending on the cause and severity.
Main symptoms
The main symptoms of turbinate hypertrophy are:
-
Difficulty breathing;
-
Stuffy nose, often alternating between nostrils;
-
Postnasal drip;
-
Headache or mild facial pain;
-
A sensation of pressure in the middle of the forehead;
-
Dry mouth upon waking;
In some cases, a runny nose, frequent sneezing, or changes in smell or taste may also occur.
Symptoms can vary depending on the cause. It’s important to see an ENT to determine the most appropriate treatment for your situation.
Confirming a diagnosis
An ENT can diagnose turbinate hypertrophy by reviewing your symptoms and medical history, including allergies and smoking habits. They will also perform a physical exam to evaluate the nasal structures.
In addition, the doctor may perform a nasal endoscopy to get a better view of the turbinates. Imaging tests, such as a CT scan, may also be ordered.
Possible causes
The main causes of turbinate hypertrophy are:
-
Anatomical changes in the nose, such as a deviated septum;
-
Allergic rhinitis or vasomotor rhinitis;
-
Normal hormonal changes during pregnancy or the menstrual cycle;
-
Menopause or hormone replacement therapy (HRT);
-
Overuse of nasal decongestants;
-
Gastroesophageal reflux disease (GERD).
Frequent exposure to irritants can also contribute, such as cigarette smoke, pollution, strong odors, or working around chemical fumes.
These factors can cause the turbinates to swell, reducing airflow through the nose and leading to symptoms.
Treatment options
Treatment for turbinate hypertrophy should be guided by an ENT. The goal is to relieve symptoms and help you breathe more comfortably.
The main treatments for turbinate hypertrophy are:
1. Nasal irrigation
Nasal irrigation with 0.9% saline solution may be recommended by a doctor. It can help thin nasal mucus, making it easier to clear and easing congestion.
2. Avoiding contact with allergenic substances
When turbinate hypertrophy is caused by allergic rhinitis, avoiding triggers is very important. Common triggers include dust, cigarette smoke, pollution, mold, pollen, and pet dander.
3. Medications
Medications used for turbinate hypertrophy, such as corticosteroid nasal sprays, can help reduce inflammation and shrink swollen turbinates.
In some cases, a doctor may recommend topical nasal decongestant sprays for short‑term relief of nasal congestion. FDA‑approved labeling for many topical nasal decongestants advises not using them for more than 3 consecutive days, because frequent or prolonged use can cause nasal congestion to recur or worsen.
If allergic rhinitis is involved, the doctor may also recommend oral antihistamines, such as loratadine or cetirizine.
4. Surgery
If medications are not enough, or if airflow is significantly blocked, the doctor may recommend surgery called a turbinectomy, which can be partial or total.
In a partial turbinectomy, only part of the enlarged turbinate is removed. In a total turbinectomy, the entire turbinate structure is removed.
Another option is turbinoplasty, which reduces the size of the turbinates without removing them and usually has fewer postoperative complications.
In some cases, surgery to correct a deviated septum may also be needed. This procedure is often done at the same time as cosmetic surgery.