Enlarged Turbinates

What is turbinate?

Turbinates are tiny structures inside the nose (on the sidewall) that cleanse and humidify the air that passes through the nose. They are bony structures surrounded by tissue rich in blood vessels and mucous membrane outside. They can become swollen and inflamed caused by allergies, irritation, or infection, causing the nasal block and producing excessive mucous, leading to nasal congestion.

 

What is the function of turbinates?

The turbinates warm, humidify, and filter inspired air before its passage to the lungs. As a result, these structures swell or contract with changes in temperature, humidity, allergen exposure, and emotional perturbations. There is also a regular, cyclical pattern of turbinate swelling, which alternates between sides at intervals of two to five hours. It is sometimes referred to as the nasal cycle.

 

What is an enlarged turbinate?

It is also known as turbinate hypertrophy, where the tissue on the nose's lateral wall (side) is swollen, thus obstructing nose breathing. 

 

What are the common causes of enlarged turbinates (hypertrophy)?

  1. Allergy. A common condition known as allergic rhinitis is the primary & leading cause of most cases of turbinates hypertrophy. The nasal allergy is due to breathing in allergens such as dust mites & pollens, which then trigger the nasal cavity's inflammation and reaction. This condition does run in the family. 

  2. Sinusitis. Sinus infections (sinusitis) happen when liquid builds up in the air-filled pockets in the face (aka paranasal sinuses), allowing bacteria to grow. Viruses form most sinus infections; however, bacteria can trigger some sinus infections. A turbinate becomes enlarged when the nasal mucosa gets inflamed because of rhinitis or persistent sinus problems. When rhinitis and sinusitis occur together, they are known as rhinosinusitis.

  3. Enlarged turbinate bones. Enlarged or unusually positioned turbinate bones can likewise cause breathing troubles.

  4. Allergic rhinitis. This allergic condition will lead to generalized inflammatory reactions along the mucosa lining of the nose. Allergic rhinitis will directly lead to swelling and congestion of both nose turbinates. A patient with an allergic nose will often present persistent nose block, frequent sneezing, itchiness of the nose and eyes, headache, and dark circles around the eyes. When examined by a doctor using a nasendoscopy, you will notice that the allergic turbinates will appear pale and bluish-gray. Inhaled allergens particles from the surrounding, such as dust mites, animal danders, pollens, and spores, are among the leading causes of allergic rhinitis. 

  5. Non-allergic rhinitis. It is a condition contrary to allergic rhinitis with no apparent cause or allergens particles. In other words, this condition is not due to allergy. Such patients will still present with nose block or congestion, runny nose, throat drippings, throat clearing, difficulty breathing, and a reduced sense of smell. Symptoms of sneezing and itchy eyes and nose are minor compared to allergic rhinitis. Examples are rhinitis medicamentosa, vasomotor rhinitis, and occupational rhinitis. Sometimes the hormonal imbalance may cause rhinitis in a situation like during pregnancy or puberty.