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Hypertrophic (Enlarged) Turbinate Bones
There are three sets of paired turbinates in the nose: Inferior, middle, and superior. Unfortunately I was only able to find information about the inferior (my problem) and middle turbinates.
Inferior Turbinate Problems
Large inferior turbinates can lead to blockage in nasal breathing. While some physicians feel that turbinate swelling has a minimal role in nasal dynamics, others believe it is a major contributor to problems. There is still controversy among physicians as to how often inferior turbinate hypertrophy needs to be treated. In addition, there is not even agreement as to the best method of treatment for enlarged turbinate bones. While some doctors will inject turbinate tissue with cortisone to decrease swelling, others believe in surgical cautery, laser, or trimming. It is best to ask your doctor to delineate the pros and cons of this treatment if it has been recommended for you. Dr. Clark chose, with my agreement, to cut some of my inferior turbinate away.
Middle Turbinate Problems
Middle turbinates can be abnormally shaped, which can lead to "nasal headaches." In addition, most of the important sinus drainage occurs just below the middle turbinate, and thus abnormal formations of the turbinate can lead to significant sinus problems.
A paradoxically shaped middle turbinate, instead of spiraling outward, curves inward, touching the nasal septum as well as narrowing the area of maxillary sinus drainage. When two structures, such as the septum and the middle turbinate, come into contact, this can set off pain fibers and result in headache. If the already large middle turbinate gets more swollen during an allergy attack, this can further block sinus drainage and cause an infection. Surgical trimming of the turbinate should correct the problem.
Normally, the turbinates are bony structures lined with nasal mucosa. If developmentally, the middle turbinate has air inside it, sinus drainage can be altered and may result in recurrent infection.
This condition, in which there is an air cell inside the normally bony middle turbinate, is termed a concha bullosa and may additionally be associated with headache. If you have a concha bullosa, then the sinus problem may be alleviated by surgically opening up this air pocket inside the turbinate; this should lead to improved sinus drainage.
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