Why do shells get bigger?
The mucous membrane of the inferior nasal turbinates is structured like a sponge with vessels: normally they either fill with blood or collapse, ensuring the nasal cycle. With constant irritation - allergen, cold dry air, dust, smoke - the vessels stop contracting, and the mucous membrane thickens and grows. Vasoconstrictor drops create a separate scenario: when used for more than a week, drug-induced rhinitis develops, when without drops the nose does not breathe at all, and more and more doses are required.
- Allergic rhinitis
- Vasomotor rhinitis
- Drug-induced rhinitis from vasoconstrictor drops
- Deviation of the nasal septum with compensatory growth of the concha
- Chronic sinusitis
- Working in dusty conditions and smoking
- Hormonal changes, including during pregnancy
Symptoms
The main complaint is congestion, which lasts for weeks and months and often changes sides depending on the position of the body. The nose stops responding to drops or reacts less and less. Breathing through the mouth leads to a dry throat, snoring, pauses in breathing during sleep, and daytime sleepiness. The sense of smell decreases, the voice changes, and a nasal tone appears. In children, prolonged mouth breathing affects the formation of bite and quality of sleep.
- Constant or intermittent nasal congestion
- Worsening of nasal breathing while lying down
- Snoring and restless sleep
- Dry mouth and throat in the morning
- Decreased sense of smell
- Headache and fatigue
- Dependence on vasoconstrictor drops
Diagnostics
The ENT doctor examines the nasal cavity, assesses the size of the turbinates, the condition of the septum and the presence of polyps; Endoscopy allows you to see posterior parts that are inaccessible to conventional examination. A test with a vasoconstrictor is important: if after it the shell noticeably decreases, the hypertrophy is reversible and you can get by with medications; if not, the changes are permanent. If sinusitis is suspected or before surgery, a computed tomography scan of the sinuses is prescribed. For seasonal complaints, it is wise to get tested for allergies.
- Examination and endoscopy of the nasal cavity
- Test with a vasoconstrictor
- Computed tomography of the paranasal sinuses
- Allergy examination for suspected allergic rhinitis
- Assessment of snoring and sleep quality
- Examination of the nasal septum
Conservative treatment
They start by eliminating the cause. Vasoconstrictor drops are canceled, replacing them with saline solutions and intranasal hormonal sprays, which safely relieve swelling with long-term use and are prescribed by a doctor. For allergies, antihistamines and measures to reduce contact with the allergen are used. Humidifying the air in the bedroom, quitting smoking, and regularly rinsing your nose help. If breathing is restored after a few weeks, surgery is not necessary.
- Complete abolition of vasoconstrictor drops
- Intranasal glucocorticoids as prescribed by a doctor
- Rinse the nose with saline solution
- Treatment of allergic rhinitis
- Air humidification and smoking cessation
- Check-up in a few weeks
Surgery for persistent hypertrophy
If the mucous membrane no longer collapses, intervention is performed on the inferior nasal turbinates. Modern techniques are gentle: through the nose, without external incisions, reducing the volume of the submucosal layer and preserving the surface of the mucosa so that the nose does not dry out. Often hypertrophy is combined with a deviated septum, and then the operations are performed simultaneously. Recovery takes several days; in the first day, the nose may be blocked due to swelling and tampons. The shells should not be completely removed.
- Submucosal vasotomy and plastic surgery of inferior conchae
- Simultaneous septoplasty for deviated septum
- Hospitalization is usually short
- Rinsing the nose during the healing period
- Complete removal of shells is not performed due to the risk of dryness
- Continuing allergy treatment after surgery
