What is Coblation of the inferior turbinates?

The inferior turbinates are structures located on the sidewall of the nasal passages. We have three sets of them: the superior, the middle, and the inferior turbinates. The largest one of them all is the inferior turbinate, which is critical in the overall function of the nose. It is also the one that may pose the biggest obstruction to nasal breathing in patients with nasal obstruction.

The inferior turbinate has a bony core as well as membrane covering. The function of the membrane is to provide moisture, filtering function, as well as air conditioning of the air before it reaches our lungs. Occasionally, the inferior turbinates could be bulky, and this could lead to nasal obstructive issues.

In patients who have not otherwise responded to medical therapy, a surgical intervention to reduce the bulk and the size of the inferior turbinates might be appropriate. Many years ago, before we became aware of the necessary functions of the inferior turbinates, surgeons used to resect the turbinates entirely to provide more room for breating. This practice has been significantly falling out of favor since we have now discovered the very essential functions of the inferior turbinates.

Other methods of reducing the bulkiness of the inferior turbinates but maintaining its overall membrane integrity have been devised. One of the better options is to use a Coblation machine to reduce the bony component of the inferior turbinates. This is done after an incision is made in the anterior tip of the inferior turbinate, and a Coblation handpiece is threaded under the mucosal membranes to the bones. The Coblation waves then slowly melt pieces of the bone while keeping the membranes over them intact.

In my practice, I usually then use a Goldman bar, which looks like a butter knife, to then displace the remainder of the turbinates sideways. This method, in my opinion, provides the greatest measure of open airways for proper nasal breathing.

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Posted in: Nose

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