Diathermy, Coablation or Trimming
The walls of the nose are lined by scroll like bones. These are called the turbinate bones. These bones warm and humidify the air we breath in. The lining of these turbinate bones (mucosa) can swell up, particularly in response to allergy or ‘common colds’. If this lining gets too large then this can lead to blocked nose.
Antihistamine tablets and steroid nasal sprays such as ‘Nasonex’ can reduce this swelling if used regularly. Decongestant sprays can also reduce this swelling, and improve breathing through the nose. However if they are used for too long (longer than 5 days), the swelling comes back very quickly and responds less each time to the decongestant sprays/drops. This is called rebound swelling, or rhinitis medica mentosa. Surgery can be used if the nasal blockage is persistent and does not respond to treatment as above.
After the surgery, it is important to use sprays to stop the lining from swelling up again.
The surgery can be:
- Trimming (cutting back) the inferior turbinates
- Cautery or diathermy (an electrical burn) to shrink down the turbinate lining
- The use of radiofrequency energy (also called Coablation and somnoplasty) to shrink back the lining of the nose
This surgery may be done as day surgery. Nasal packs are generally avoided, although are often necessary if the turbinate bones are trimmed. After surgery, nasal washouts and drops are used to improve healing. It takes up to one month for the breathing to improve after this surgery. It is important to use sprays such as Nasonex after the nose has healed. This prevents the lining from swelling up again.