Laser conchotomy (laser turbinate reduction, laser turbinate reduction, laser turbinate reduction) is a surgical procedure to reduce an enlarged turbinate. Nasal concha with the help of a special laser. The amount of air inhaled is regulated by the swelling and shrinking of the turbinate and the shape of the nasal septum. The breathing air is tempered, humidified and filtered. If the turbinates are blocked by Nasal drip addiction, Chronic inflammation or Allergies If the nasal septum is enlarged or bent, nasal breathing is impaired. General performance is significantly reduced.
Furthermore, obstructed nasal breathing can lead to diseases of the paranasal sinuses, throat, bronchial tubes and ears, as well as sleep-related breathing disorders.
Laser conchotomy is performed as an outpatient procedure under local anaesthetic.
A diode laser is used in our practice to carry out the procedure. A clinical study has shown that the laser can be used to achieve an 80 per cent success rate in the treatment of turbinate hyperplasia. With the help of the laser beam, which has a wavelength of 980 nm and is therefore in the infrared range, the turbinates can be reduced in size elegantly and almost completely painlessly.
A significant advantage of this procedure over conventional conchotomy is that the use of lasers results in a virtually bloodless operation, which can also significantly reduce the risk of post-operative haemorrhage. Furthermore, this procedure is much gentler, meaning that the patient's recovery time after the operation is relatively short.
Laser therapy enables successful treatment of nasal obstruction based on the latest medical findings. Laser treatment of the turbinates causes targeted shrinkage and scarring in the tissue so that the turbinates can no longer swell and nasal breathing remains unobstructed. It therefore has the same effect as the use of nasal drops without their adverse effects.
Although laser conchotomy has a low risk of post-operative bleeding due to the sclerotherapy of the blood vessels parallel to the incision, it is still necessary to discontinue anticoagulant medication such as Marcumar or acetylsalicylic acid (ASA) a few days before the surgical procedure. By temporarily discontinuing the medication, the risk of secondary bleeding is significantly minimised without a significant increase in risk for the patient.
As nasal tamponades are not used after the operation, the use of special sprays is essential. By using these preparations in the area of scarring, it was even possible to histologically (microscopically) demonstrate regeneration of the respiratory epithelium after a few months.
The nostrils are regarded as two external entrances into the left and right nasal cavities. Inside them, three turbinates protrude into the nasal cavity from the side of each nostril - the upper, middle and lower turbinates. They consist of thin bone plates and are covered with mucous membrane. Between them lies the so-called cavernous body, which is made up of a densely branched network of very fine blood vessels.
The main task of the turbinates is to warm the air we breathe, humidify it and clean it of dirt particles and germs. They use small hairs to do this.
If breathing is normal and calm, the turbinates are supplied with more blood and expand. If more air has to flow through the nose quickly - e.g. during sport or physical work - the body reduces blood flow. This causes the turbinates to contract.
By adapting to the respective situation, the nasal concha can generally always optimally warm, filter and humidify the inhaled air.
"Healthy" turbinates dilate at rest and contract during physical exertion. In some patients, however, the turbinates are permanently enlarged. This makes breathing difficult and can cause various symptoms.
Patients who suffer from so-called turbinate hyperplasia show many different symptoms. The inferior turbinates are usually affected. An enlarged turbinate is unpleasant at this point, as the nasal passage lies beneath them. This provides the connection to the airways. As a result, affected patients have the feeling that their nose is permanently blocked. They have problems breathing and are unable to breathe properly - for example in a dry room climate.
The problem often worsens when lying down, as the turbinates are supplied with more blood in this position and therefore swell further. Patients therefore have to breathe more through their mouth. This dries out the mucous membranes. Speaking, eating and drinking can become more difficult. Nosebleeds can also occur more frequently. As the inhaled air cannot be cleaned properly, the susceptibility to infection is also increased. Ventilation problems in the middle ear, which can be accompanied by a feeling of pressure, occasional hissing, pain in the ear and cracking and clicking noises, are often further symptoms of turbinate hyperplasia. Snoring at night can also be attributed to turbinate enlargement in some cases.
Permanently swollen turbinates are usually caused by an excessive reaction of the nasal mucosa to certain stimuli (nasal hyperreactivity).
The following factors can lead to permanently enlarged turbinates:
If you suffer from the above symptoms and suspect that you have enlarged turbinates, then you should make an appointment with us at the ENT practice clinic Goethe 10 in Frankfurt.
Dr Thomas Fischer will first take your medical history at your appointment and ask you specifically about your symptoms. They will also want to know whether you are taking certain medications, suffer from allergies or are exposed to specific pollutants.
Per Rhinoscopy (rhinoscopy; endoscopic examination of the nose), Dr Fischer can clearly identify swollen turbinates and their internal triggers - such as a deviated nasal septum or diseases of the paranasal sinuses. He often uses ultrasound and/or carries out an allergy test to make a diagnosis. If these examinations are not yet conclusive enough, other imaging procedures (e.g. CT or MRI) can be used.
Dr Thomas Fischer will make the treatment dependent on the cause. This means, for example, that allergens should be avoided and an enlargement of the turbinates caused by allergies should be treated with medication if necessary. The allergy symptoms, including the permanent enlargement of the turbinates, usually disappear under therapy.
If another cause is to blame for the enlarged turbinates or if the medication used does not bring about a lasting improvement, surgical procedures can be used. These also depend on the findings. If the symptoms are due to a curved nasal septum, for example, it may be advisable to straighten it surgically.
Laser conchotomy, a special laser treatment that can be used to reduce the size of enlarged turbinates, is also ideal.
Examples of typical indications/areas of application for laser conchotomy are
If the patient is suffering from an acute infection in the ENT area, treatment must not be carried out.
With laser therapy, you can benefit from effective treatment of your nasal obstruction - based on the latest medical findings.
Laser conchotomy achieves targeted shrinkage and scarring of the tissue. This means that the turbinates can no longer swell excessively and nasal breathing remains free. You can visualise the treatment result as follows: It is comparable to the use of nasal spray, but the effect is permanent and has no long-term detrimental effect.
Although laser conchotomy is a tissue-sparing and painless procedure that can be performed on an outpatient basis and is usually accompanied by rapid healing, complications can still occur, albeit rarely:
Not all health insurance companies cover the costs. Although statutory health insurance companies cover turbinate reduction by means of incision (conchotomy) and/or sclerotherapy using electricity (conchotomy), laser treatment is not included in the catalogue of services provided by statutory health insurance companies. This is a self-payer service. The individual costs will be discussed with you after a detailed examination. Private health insurance companies generally cover the costs.
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