The inferior nasal turbinate is an important structure located in the nasal cavity. Often described as a “finger-like projection”, the inferior nasal turbinate extends from deep inside the nose towards the anterior (front) nasal cavity. It is one of three pairs of nasal turbinates that are orientated in “shelf-like” fashion within the nose.
Functionally, the inferior nasal turbinates are responsible for directing air into the nasal cavity and cleaning/humidifying it. Sometimes the turbinates are large enough to cause difficulty with nasal breathing. This condition is called, “inferior turbinate hypertrophy”. Enlarged nasal turbinates can be caused by a variety of issues, including seasonal allergies, chronic sinusitis, or anatomical factors such as a deviated nasal septum.
Common symptoms of inferior turbinate hypertrophy include nasal congestion, difficulty breathing through the nose, chronic sinus infections, and snoring at night. Diagnosis of the condition usually requires examination by an Ears, Nose, and Throat specialist (otolaryngologist). To further investigate, a quick and painless in-office procedure called a nasal endoscopy will likely be performed. This includes the physician guiding a thin, flexible endoscope into the nasal and sinus cavities to evaluate if nasal turbinates are enlarged. Often other abnormalities of the nose can also be identified, such as a nasal septal deviation, chronic sinus swelling, sinus cysts, or enlarged adenoids.
Medications that reduce inflammation in the nose are often used to treat inferior turbinate hypertrophy. These include intranasal steroid sprays (Flonase, Rhinocort, Nasonex), sinus irrigations with steroids (Pulmicort/Budesonide), and periodic courses of oral steroids. Over the counter antihistamines such as Claritin or Zyrtec may also be helpful. If inferior turbinate hypertrophy does not improve with medical therapy, surgical procedures can be considered. One procedure, called the inferior turbinate reduction, is performed to reduce the size of the nasal turbinates. This can be performed in both the office and hospital operating room setting.
If you or family members have concerns regarding hypertrophy of the nasal turbinates, please do not hesitate to contact Colden and Seymour Ear, Nose, Throat, and Allergy to set up an appointment. Opinions expressed here are those of Daryl Colden, MD, FACS, and Christopher Jayne, BA. These opinions are not a substitute for a medical evaluation performed by a medical provider.
Do you feel that your allergy symptoms get worse during the late spring and early summer? It’s possible that you may have a grass allergy. The summer season is grass pollination season, causing an array of bothersome symptoms in individuals who are allergic to it. The condition is called seasonal allergic rhinitis.
Common complaints of allergic rhinitis include recurrent sneezing, a runny nose, water/itchy eyes, postnasal drip, nasal congestion, or throat congestion. Those with severe grass allergies may report itchiness of the skin or urticaria (hives) after contact with grass. Other conditions that are associated with grass allergies include asthma, eczema, conjunctivitis, nasal polyps, sinusitis (sinus swelling), sleep apnea, laryngitis, and ear infections. Some individuals with grass allergies may also suffer from oral allergy syndrome (OAS), a condition marked by itchiness of the mouth and throat after consuming raw fruits and vegetables (tomatoes, potatoes, peaches).
The first step in minimizing allergy symptoms is to see what grass pollens you are allergic to. This can be accomplished via allergy testing. Patients are often tested for several different grass species usually dependent on which grasses are found in their area. A typical New England panel may include Rye grass, Bermuda grass, Timothy grass, Bahia grass, and Johnson grass. Allergy testing can be performed via a quick, pain-free skin test or by a blood test, which is often sent away to a reference lab. Both testing methods are safe and effective for diagnosing grass, as well as other types of environmental allergies. Skin testing is advantageous in that it can be performed in the office setting, the results are readily available, and multiple grass allergens can be tested.
Modifying your environment can be very effective way to decrease grass allergy symptoms. This includes keeping home windows closed, staying indoors on high pollen days, not drying clothing outside, showering before bedtime, and wearing appropriate clothing when mowing the lawn. Medical management includes over the counter antihistamines (e.g. Claritin, Zyrtec) and intranasal steroid sprays (e.g. Flonase), decongestants as well as some other otc type medications. For patients who are interested in long term improvement and decreased usage of allergy medications, immunotherapy can be considered. Immunotherapy is a method to improve the body’s immune system against those allergens that one is reacting to negatively. Immunotherapy can be administer subcutaneously (SCIT – “allergy shots”) or sublingually (SLIT – “allergy drops”). Multiple studies over the past 50 years have consistently demonstrated that SCIT is a safe and effective way to minimize allergy symptoms. SLIT is the most common form of allergy treatment in Europe and many studies have show it to be as safe and effective as traditional “allergy shots”. The major disadvantage for SLIT is that it is currently not FDA approved (although the drops are made from the exact same extract as allergy shots), and therefore this treatment would not be covered through medical insurance. Many of our patients have been successfully treated with both types of immunotherapy over the past 15 years.
If you or family members have questions or concerns regarding grass allergies, please do not hesitate to contact Colden & Seymour Ear, Nose, Throat, and Allergy to schedule an examination. Opinions expressed here are those of Daryl Colden, MD, FACS, and Christopher Jayne, BA. These opinions are not a substitute for direct medical evaluation and advice.