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Radio wave coagulation of shells. Vasotomy of the nasal turbinates - what is it and how is it performed?

Laser coagulation of the nasal mucosa is effective way get rid of all signs of chronic rhinitis.

Contraindications:

    • availability inflammatory process in the body (ARVI, acute respiratory infections, influenza, sinusitis, pharyngitis, tonsillitis, laryngitis, bronchitis, pneumonia, etc.);
    • blood clotting disorder.

Equipment used:

  • ultrasonic device "Tonsillor - M";
  • modified vacuum nozzle for washing the tonsils;
  • vacuum nozzle "Tonsillor" for washing the tonsils;
  • syringe for washing the tonsils.

Often patients do not pay due attention to the processes in the body, especially when they are worried the only symptom- runny nose. Advertising offers many means to “relieve” the condition. So what's the result? The patient himself prescribes therapy, uses sprays and drops. At some point, they stop helping, and the runny nose and difficulty breathing do not go away. A person seriously develops the disease, and there is only one way out - surgery. Laser coagulation of nasal vessels (cauterization) in Moscow is indicated for all types of chronic rhinitis:

  • vasomotor (nasal vessels lose tone);
  • allergic (when, in response to a certain irritant, the vessels of the mucous membrane become clogged);
  • medicinal - occurs with prolonged use of drops;
  • hypertrophic - a companion to the rhinitis described above, in which the nasal mucosa increases.

If the doctor has made one of these diagnoses, you will be offered a surgical treatment method - laser coagulation of the nasal mucosa (cauterization). She allows in short term alleviate the condition without resorting to hospital treatment.

Our doctors

How is the operation performed?

Coagulation of the mucous membrane with a laser is a non-traumatic and effective method that helps get rid of all signs of chronic rhinitis and allows you to breathe fully on the day of surgery. During the operation, the doctor uses a special laser to cauterize the vessels, as a result of which the swelling disappears and breathing is restored.

The operation itself lasts about 15 minutes. Before the procedure, the doctor applies local anesthesia. The patient should not move his head while the laser is working. The laser gently affects desired area without touching adjacent ones. The patient does not experience any unpleasant sensations - only tingling. The doctor monitors what is happening using an endoscope. After the operation, the patient receives valuable instructions that must be carefully followed:

  • Do not use medications for the nasal cavity;
  • avoid physical activity;
  • Baths, saunas, and drinking alcohol are contraindicated.

If one procedure is not enough, the doctor will prescribe a repeat session. But this happens extremely rarely.

A significant advantage of the operation is its long lasting effect And affordable price. Patients after it may not remember their illness for many years.

Certificates and licenses

Treatment in Moscow in our clinic is carried out using modern equipment and sterile instruments. Our prices have not changed since 2013, and are the best in the city. Laser coagulation - best way treatment of chronic rhinitis. To chronic stage It’s better not to let it go, but if the disease is advanced, be sure to come. We will help you!

The natural ability for nasal breathing can be greatly impaired by hypertrophy of the nasal mucosa. And sometimes such a problem can only be dealt with through surgical intervention.

In response to a severe runny nose, the venous plexuses, which are localized in the nasal mucosa, enlarge. As a result of their swelling, the normal lumen of the nasal passages narrows, which leads to breathing difficulties.

With some types of runny nose, the venous plexuses become constantly overflowing with blood. This situation is possible when:

  • Allergic rhinitis.
  • Vasomotor rhinitis.
  • Drug-induced runny nose.

Normalize nasal breathing in such conditions it is possible to use radical correction methods. Surgical intervention is designed to reduce the volume of shells while maintaining their mucous membranes and shape.

Laser coagulation

At laser coagulation In the lower turbinates, part of the mucous membranes in the nasal passages is destroyed with a special laser beam. It can act evenly over the entire affected area, leading to evaporation pathological cells. Laser destruction is a synonym for laser coagulation.

This therapy technique is used in cases where conservative treatment does not give the expected effect. Indications for its implementation:

  • Chronic form of rhinitis.
  • Proliferation (hypertrophy) of the nasal mucosa.
  • Long-term use of vasoconstrictor medications, without which free breathing becomes impossible.

Determine if you need laser destruction of the inferior turbinates in a specific situation, a qualified otolaryngologist will help after a detailed examination.

Contraindications

Like everyone else medical manipulations, laser coagulation of the inferior turbinates has certain limitations:

  • Presence of acute respiratory infections and other acute inflammatory diseases at the time of the intervention.
  • Purulent processes in the nasopharynx, oral cavity or paranasal sinuses nose
  • Having problems with blood clotting.
  • The period of bearing a child.
  • Presence of epilepsy.
  • Presence of a pacemaker.
  • The period of menstruation in the fair sex.
  • Presence of decompensated diabetes mellitus, suffered a heart attack or stroke.

How to prepare?

Before performing laser coagulation, the patient needs:

  • Pass general tests blood and urine.
  • Do an ECG.
  • Carry out other tests prescribed by your doctor.
  • Avoid taking medications that thin the blood.
  • Stop drinking alcoholic beverages.
  • Do not perform cosmetic procedures.
  • Do not use decorative cosmetics.

All restrictions must be observed for several days before laser destruction.

How is it carried out?

Immediately before laser coagulation, the patient:

  • Blood pressure readings are measured.
  • They talk about the features of the upcoming intervention.
  • They offer to change into disposable clothing - a robe with shoe covers and a cap.
  • They suggest going to the operating room.
  • Give sedatives if necessary.
  • They suggest lying on a couch, the head end of which is raised. It is important to take the most comfortable position possible.
  • A blindfold is put on the eyes, the limbs are fixed (if the patient does not mind), because any unexpected movements are fraught with burns.

Progress of the intervention:

  • The doctor introduces local anesthetic in the form of an injection or using turundas soaked in medicine (they are placed inside the nasal passages for a couple of minutes). Sometimes the painkiller is given as a spray.
  • The patient's face is treated with an antiseptic - 70% medical alcohol.
  • In order for the doctor to visually see the place where the condition of the nasal mucous membranes has deteriorated, they are stained with a solution of methylene blue. It is believed that such treatment can also improve laser performance.
  • After this, the doctor proceeds directly to destruction. To do this, he touches the problem area with a laser. Destructive processes are completely painless and allow you to preserve the integrity of the surface layers of the mucosa, as well as the cilia of the ciliated epithelium. The only unpleasant sensation that the patient may experience is a slight tingling sensation.
  • During surgery, the patient must breathe exclusively through the mouth. An unpleasant odor is heard during laser coagulation.
  • The intervention is monitored using a special surgical mirror or endoscope.
  • After completion of treatment, the patient can go home within 1–2 hours.

In principle, laser destruction of the nasal turbinates is carried out in all clinics according to the same scheme. Only some differences in the work of a specialist are possible.

Advantages

Laser coagulation has a lot of advantages:

  • The operation lasts about ten minutes (rarely more), after which only small wounds of about one or two millimeters remain. Tissue damage is minimal.
  • There is no bleeding after surgery, so there is no need for nasal packing.
  • The patient needs to be in inpatient department about two hours, no more.
  • This intervention does not require hospitalization.
  • Postoperative wounds practically do not hurt.
  • Regeneration processes proceed at an accelerated rate.
  • The laser has sterilizing properties, which reduces the risk of developing postoperative complications.
  • The tissues heal completely, there are no rough scars left on them.
  • Therapy allows you to achieve a lasting therapeutic effect.

According to statistics, destruction of blood vessels with a laser can cure various types rhinitis and restore the activity of the nasal mucous membranes in 96% of cases.

Recovery

For successful rehabilitation after laser therapy the patient needs to follow a few simple recommendations:

  • Do not lead an active lifestyle, give up sports and bending for a while.
  • Not in heat, sauna, bathhouse, etc.
  • Stop drinking alcohol.
  • Do not use vasoconstrictors.
  • Use medications prescribed by a doctor (drugs that promote tissue regeneration, oils, etc.).

After laser coagulation of the turbinates, the patient’s ability to breathe through the nose returns after just three days.

Possible complications

Laser destruction extremely rarely causes complications, but can contribute to:

  • Disappearance or complete loss of sense of smell. This phenomenon is considered temporary.
  • Feeling of nasal congestion or breathing problems (possibly due to repeated hypertrophy or allergies).
  • Development of the inflammatory process.
  • Atrophy of the mucous membrane.

As a rule, laser destruction of the nasal turbinates occurs without complications and allows the patient to breathe fully through the nose again.

February 14, 2018 04/28/2018

Question:

Hello, Andrey Vladimirovich.
I have been to 3 lors. Everyone diagnosed me vasomotor rhinitis. I'm dripping drops
in the nose 2 Xylene" 3-4 times a day for
5 years. I recommend all ENT doctors different procedures for treatment. One recommended
submucosal vasotomy of the inferior turbinates. Second radio wave
disintegration of the inferior turbinates. Third laser destruction of the lower nasal
shells What's the difference? Which of these operations is better? you make these
operations?


Answer:

Good afternoon. The complaints you described
characteristic of the diagnosis: Vasomotor rhinitis (medicinal rhinitis,
"Naphthyzine addiction"). To reduce the volume of the inferior turbinates
partial destruction of the cavernous tissue of the inferior turbinates is performed.
After such manipulations, the nasal turbinates decrease in size, and you breathe well through your nose, as after instilling drops. All listed
Your methods allow you to solve this problem, only the equipment is different,
used for the operation. Submucosal vasotomy of the inferior turbinates is often
bleeding and requires nasal tamponade for a day. Walk with tampons
My nose feels uncomfortable for a day. Impact on the inferior turbinates using
laser and radio waves are no less effective. The main thing is that this impact
was necessarily carried out under the mucous membrane of the inferior nasal concha. Such
the method preserves the mucous membrane of the inferior nasal concha and affects
only on cavernous tissue. Laser destruction of the inferior turbinates and radio wave
disintegration of the inferior turbinates practically does not cause bleeding and
Tampons are not placed in the nasal cavity. This is convenient for the patient, because No
the need to return for a follow-up appointment to remove tampons. Nose after
laser destruction of the inferior turbinates or radio wave disintegration
will breathe poorly for 2-5 days due to post-operative swelling, in
In the future, nasal breathing will be restored. We master all available methods
treatment of vasomotor rhinitis (submucosal vasotomy, radio wave
disintegration of the inferior turbinates, laser destruction of the inferior nasal
shells). The decision to choose a treatment method is made together with the patient
consultations.

Below is a video of the operation we
usually performed for vasomotor rhinitis (medicinal rhinitis, Naphthyzin
dependencies").

Sincerely, Lunev Andrey Vladimirovich

Vasotomy is an operation aimed at reducing the size of the nasal mucosa. It comes down to the destruction of a part choroid plexuses located between the epithelium and bone. The main indication is chronic runny nose and the resulting hypertrophy of the mucous membrane.

Indications for surgery

The main disease for which vasotomy is possible is a chronic or runny nose. An important condition surgical treatment is to get rid of the underlying infection and exclude the allergic nature of the disease.

Hypertrophy of the nasal mucosa can also be a reason for prescribing vasotomy. These two pathologies are related, but not directly. Hypertrophy may be a consequence persistent runny nose, reception vasoconstrictor drugs, which suppress its function and cause the mucous membrane to grow to compensate. But it can also arise as a result. Hypertrophy often increases during adolescence.

Vasotomy can help with addiction vasoconstrictor drugs. In this case, the swelling does not subside without taking the appropriate drops. For some people, addiction can last for years, and only surgery helps them begin to breathe on their own.

Operating principle

The operation area is the inferior nasal turbinates. X surgery may affect only the left or right side or be two-way. The latter option is performed most often, since vasomotor chronic rhinitis affects both nostrils.

The inferior turbinates are bony protrusions that are covered with epithelium containing many glands. Because of them, the surface is constantly wetted with mucus and is therefore called mucous. It is characterized by increased blood circulation. Therefore, another layer is usually isolated between the bone and epithelial tissue - the submucosal layer. It consists of choroid plexuses.

They are the ones that are destroyed during the operation. As a result, nutrition of this part of the epithelium stops. It dies and scars appear. The total volume of hypertrophied mucosa decreases. This relieves swelling, reduces the activity of the glands, which ultimately eliminates the runny nose.

Types of surgery

Vasotomy of the inferior turbinates can be performed using one of the following methods:

  • Instrumental. In this case, the surgeon acts directly with a scalpel, making an incision into the mucous membrane.
  • Laser. The action of the beam is directed to the entire surface of the mucous membrane. The risk of infection is reduced, but the effectiveness does not always correspond to the damage caused.
  • Radiocoagulation. The surgeon makes punctures; an instrument with a tip through which radio waves pass is inserted.
  • Vacuum resection. This new method, which is on at the moment is being actively researched. The destruction of the submucosal layer is carried out by introducing a tube connected to a pump under the epithelium and creating negative pressure.
  • Ultrasonic disintegration. The waves are focused exclusively on the affected area. Risk additional damage minimal.

Progress of the operation

Instrumental vasotomy

The procedure is carried out under local anesthesia. It is carried out by lubricating the mucous membrane with a 5% solution of cocaine or a 2% solution of dicaine. The entire nasal turbinate is also infiltrated (impregnated) with lidocaine (1%) or novocaine (1-2%). Sometimes they are given by injection. The patient's face is covered with a napkin, leaving an opening for the nose. Thus, the patient does not see the doctor’s actions. The operation time is from 30 to 60 minutes.

After the anesthetics begin to take effect, the surgeon makes a 2-3 mm incision down to the bone. A raspatory, a tool for separating tissue, is inserted into it. The surgeon separates the mucous tissue in the required volume. As a result, scars appear at the site of the choroid plexuses, and the epithelial tissue decreases in size.

Sometimes lateropexy is necessary– shift of the nasal concha to the side maxillary sinus. The patient may hear a crunching sound at this moment; do not be alarmed and try to move your head.

After the operation, the patient is given another injection with an anesthetic, to reduce discomfort after the anesthesia wears off. Bandages or tampons will remain in your nose for some time. In the first day, the condition may resemble flu - lacrimation, weakness, dizziness. Important! However, there should be no temperature - this is a sign of inflammation or infection. The patient will need to rinse his nose periodically in the morning to prevent crusting. This procedure is carried out until the mucous membrane is completely healed and its normal functioning begins.

Laser vasotomy

Before surgery, you must refuse cosmetics. It is possible that the patient will be asked to change into disposable hospital pajamas. The operation is performed under local anesthesia. The pain medication is most often delivered in the form of tudundas soaked in analgesic, which are inserted into the nose. The patient's face is treated with alcohol.

Sometimes, as a result of changes in the mucous membrane, it loses color and becomes pale. In such a situation, it is difficult for a doctor to carry out all the necessary manipulations, so before the operation the epithelium is stained with methylene blue. This also improves the performance of the laser.

The patient lies on the couch, his head is placed on the headrest. Important! It is extremely undesirable to move during the operation, so you need to immediately take a comfortable position. If the patient feels overly excited, it is better to ask the doctor to immobilize the arms and legs with elastic bandages. A blindfold is put on the eyes. During the operation, the patient will feel an unpleasant burning smell. It will be optimal if he inhales through his mouth and exhales through his nose.

The doctor inserts a mirror into the nose and uses it to control the process. It is usually painless, but a slight tingling or pinching sensation may occur. Radiation can be carried out pointwise or continuously, when the doctor runs the laser along the mucous membrane. The first method is the most preferable because it has less impact on the epithelial lining of the nose. Today at medical centers First, they use the least traumatic method, and if it is ineffective, they move on to the second.

The actual operation is carried out with quartz fiber. It is injected under the mucosa and forms channels there, separating the tissue. The fiber is flexible, which allows it to follow all the contours of the nasal concha and not extend to the surface of the epithelium.

After the operation, tamponade (insertion of tampons into the nose) is not required, since in most cases it is bloodless, because the vessels are not cut, but “sealed”. This prevents the development of synechiae - tissue adhesions. Laser vasotomy has good efficacy and safety indicators. As doctors from Kharkov write (O.G. Garyuk, A.B. Bobrus), who conducted a long-term study of patients with drug-induced rhinitis in the period from 2006 to 2009, cure occurs in 96.8% of cases.

Video: performing laser vasotomy

Radio wave vasotomy

The patient's immobility is one of the key parameters, so in most cases the patient falls asleep during the operation. The anesthetic is delivered through a vein. A tube is placed in the throat to drain the blood. Operation time is from 10 to 40 minutes. If the doctor uses local anesthesia, then the patient should control his reactions as much as possible during radio wave vasotomy and try not to move even in case of severe pain.

The doctor inserts a probe into the submucosal area. A radio wave appears between it and the transmitter. Due to wave resistance the surrounding tissues heat up and are destroyed. One variation of the method is the use of non-thermal energy. At certain frequencies, a cooling area appears around the inserted probe, which causes tissue destruction. This method is considered somewhat less traumatic than the standard one and safer for neighboring tissues.

The patient usually wakes up 1-2 hours after the end of the operation in the ward. There are tampons and tubes in the nostrils through which you can breathe. General condition the patient is satisfactory. Patients usually note severe pain in the nose and prefer to breathe through the mouth. Migraines and spatial disorientation are possible. During the week, it is necessary to observe hygiene measures - rinsing the nose saline solutions, such as Aquamaris, removing crusts from the nose using Vaseline or peach oil.

Ultrasonic disintegration

The operation is performed in the ENT office. She carried out under local anesthesia and lasts from 5 to 20 minutes. There may be some bleeding, so the patient will likely be wearing a special apron. A waveguide is inserted into the submucosa of the patient's inferior turbinates. It looks like a needle, with which the doctor “pierces” the epithelium.

The ultrasound emitted causes stenosis (sticking together) of those blood vessels which provoke swelling. After the operation is completed, tampons are inserted into the patient's nostrils and he can go home. In the evening, ichor may be released - this is a normal reaction. Nasal breathing is completely restored 3-7 days after surgery. It is necessary to periodically see a doctor to remove crusts of mucus during the recovery period.

Vacuum resection

The operation is performed under local anesthesia and under strict endoscopic control. A device for performing vacuum resection was developed by Russian doctors and put into practice just a few years ago. It is a system of tubes with a pump attached to them.

The surgeon makes an incision with a scalpel after the onset of anesthesia. A tube is inserted into the submucosal layer. Its edge is sharp, and as it moves, it cuts off the tissue needed to be removed. Due to the action of the pump, they are sucked into the tube along with the blood.

After removing the device from the nose, it is inserted into the nostril cotton ball which presses tightly epithelial tissue. This is necessary to prevent bleeding. It stays in the nostril for only 30-60 minutes. Tamponade is not required for vacuum resection.

Deleted content is sent to histological examination. This allows for more careful planning of further patient management.

Vasotomy combined with septoplasty

stages of septoplasty

One more common cause breathing disorders in addition to hypertrophy of the mucous membrane is a curvature of the nasal septum. This pathology can also be corrected surgically. The operation is called . Since chronic rhinitis and deviated septum - associated diseases, it is often suggested to carry out immediately this operation together with vasotomy.

Similar surgery is more severe than just excision of the submucosal layer of the nose, and lasts longer. Therefore, in this case, more often They practice general anesthesia and hospitalization for 1-2 days after surgery. And yet Most surgeons recommend performing septoplasty and vasotomy together rather than in two stages. This reduces trauma to the mucous membrane and discomfort for the patient, which only has to be experienced once.

The recovery period after such an operation lasts longer than with a conventional vasotomy. There may be an increase in temperature and prolonged separation of ichor from the nose. Important! If you feel unwell, you should contact your ENT specialist; only a specialist can distinguish the body’s normal reaction from the onset of an infectious process.

Complications after vasotomy

After surgery, the following undesirable consequences may develop:

  1. Atrophy of the mucous membrane. This is the reverse process of hypertrophy, but also unpleasant. The lowest risk of its occurrence is after laser exposure. Atrophy is caused by functional destruction significant cells epithelium of the nasal passages.
  2. Inflammation. The risk of infection during surgery is quite low. All tools, both private and public clinics undergoes sterilization. However, any surgical intervention reduces the protective barrier of the epithelium, which makes the body more susceptible to various pathogens. The more invasive the method is used, the more likely get inflammation.
  3. Loss of sense of smell. This is usually a temporary phenomenon associated with post-operative swelling.
  4. Nasal congestion. Unfortunately, nasal vasotomy may not always help. It is extremely rare that swelling and congestion not only do not go away, but also become stronger. The reasons may vary from allergic reaction until re-hypertrophy.
  5. Formation of synechiae or adhesions at the resection site. These formations can seriously make breathing difficult. They form gradually, so the patient’s well-being may not deteriorate immediately. Treatment is carried out only through repeated surgery.

Some authors do not consider the safety of the effects of physical radiation (radio or laser) on the human body to be conclusively proven. Modern research are not grounds for prognosis of the patient's condition in the more distant future.

Price

Submucosal vasotomy is performed free of charge, but you will have to stand in line to receive the service. Patients usually have to wait from 1 to several months. The operation is carried out mainly instrumental method. It is possible, if the clinic or hospital has special equipment, to perform vacuum resection according to compulsory medical insurance policy However, this practice is still extremely rare.

Other types of vasotomy cost approximately the same - from 5,000 to 15,000 rubles. Additionally, you will have to pay for general anesthesia if such is the doctor’s indications or the patient’s wishes. The cost of tests, biopsy of the contents, as well as hospitalization beyond the first day are not included in the indicated price. Clinic price lists usually imply bilateral vasotomy, although this is not indicated separately.

The most expensive operation will be combined with septoplasty, mainly due to hospital stay. Average price in Moscow is 50,000 rubles. But septoplasty itself can be performed free of charge under the compulsory medical insurance policy, but you should not expect the combination of this operation with vasotomy performed using a minimally invasive method using modern equipment.


To perform radiofrequency/radio wave submucosal optical (video) endoscopic reduction/coagulation of the inferior turbinates, the following is required:

You can take tests anywhere– in a clinic at your place of residence, having previously applied for referrals to a local physician, or in any private laboratory.

To save your time, test results (in the form of a scanned or photographed image) together with patient data and a telephone number for feedback are sent by email ( [email protected] / [email protected]) or Viber/WhatsApp/iMessage (+7-912-938-04-88).

The date of the operation is determined after you send me the test results; usually the day and time of the operation are agreed upon with the patient individually.

Before taking tests, ask about email the doctor about the schedule of operations - the schedule may change - I may be on vacation, on sick leave, etc.

After I receive the test results and analyze them, I will respond within 24 hours email In the attachment I will send you all the documents necessary for hospitalization (a referral with the date of surgery, necessary recommendations, consents, etc.) with a request that you carefully read them, and the next day I will call you back and answer all your questions. After which we will meet on the day of the operation.

If the test results are unsatisfactory, I will call you back soon after receiving them and notify you that the operation is impossible.

The operation is being carried out outpatient (without 24-hour hospitalization).


The doctor uses a radio wave apparatus for ENT in case of persistent difficulty in nasal breathing, as well as in the absence of effect from vasoconstrictor drops into the nose, for diseases such as chronic vasomotor rhinitis and chronic hypertrophic rhinitis, as well as for snoring (ronchopathy).

Using an ENT radio wave apparatus, the doctor performs an operation - radio wave coagulation of the inferior nasal concha. This medical ENT manipulation is minor surgery, one of the advantages of which is the ability to operate on a patient without hospitalization (outpatient), and the short period of rehabilitation and recovery after surgery, due to the less pronounced swelling of the mucous membrane of the inferior turbinates, allows you to safely give it preference and put it in first place, according to compared to others surgical methods treatment.

The operation takes no more than 1 hour, with most of the time spent on “preparation” (anesthesia). First, the ENT doctor performs local application anesthesia by placing a cotton swab moistened with a solution of dicaine with adrenaline into the nasal cavity. Then the ENT doctor performs a local infiltration anesthesia, making injections (injections) of Ultracaine DS-Forte into the thickness of the inferior nasal concha.

For high-quality and adequate pain relief, it is recommended to perform two injections into each lower turbinate. At the same time, the patient practically does not feel the injection of the needle, but may feel slight tissue tension due to the “expansion” of the drug in the anterior sections of the inferior turbinate.

The effect of the drug is immediate, and the effect of anesthesia lasts about 3–4 hours, which makes it possible to guarantee the operation of the patient with high-quality anesthesia.

The patient does not feel the second injection, since it is essentially conduction anesthesia, through the front in posterior sections inferior nasal concha. Then the ENT doctor gives the patient the opportunity to get ready for the operation, while the action medicines is gaining full strength.

The ENT doctor performs radio wave coagulation of the inferior turbinates by inserting an electrode into the thickness of the inferior turbinate for 3 – 5 – 10 – 20 seconds, depending on the severity of the chronic process.


Another important advantage of this ENT operation is the 100% sterility of this method. This is achieved due to the fact that when you press the pedal and apply a radio wave to the electrode, within 1 millisecond all living things (bacteria, fungi, viruses, vibrios, spirochetes, protozoa and other microorganisms) that are on the metal spokes of the electrode (working surfaces) ) dies, unable to withstand ultra-high temperatures. At the same time, it is important that the ENT patient does not have a cold and is not sick at the time of the operation with such diseases as: acute respiratory infections, acute respiratory viral infections, sinusitis, pharyngitis, tonsillitis, laryngitis, bronchitis, tracheitis, pneumonia and other acute and chronic bronchopulmonary diseases. This guarantees the ENT patient the “sterility” of this operation.

With direct radio wave exposure, the patient either does not feel anything or feels a slight, but very tolerable burning or tingling sensation in the nose. Due to the high speed of radio wave exposure, all negative sensations of the patient are minimized.

Another great advantage is the so-called controllability of this operation, since the ENT doctor has the ability to set the required frequency of exposure. In fact, this is the force of the radio wave on tissue human body. Also, the ENT doctor has the opportunity to regulate the exposure, that is, the duration of exposure, at his discretion.

The most important and useful condition is that the ENT doctor has the ability to suspend the operation at any time or stop it altogether. Unfortunately, today this is not possible with all operations, including those on ENT organs.

After surgery on the inferior turbinates, the ENT doctor places (may install) cotton swabs in the nasal passages in order to avoid possible bleeding and prevent the development of severe swelling of the operated mucous membrane of the nasal cavity.

If necessary, the patient removes cotton swabs independently. next morning after the operation, or can contact the clinic where the operation was performed. 10 - 15 minutes after removing the tampons, it develops postoperative edema tissues of the inferior turbinates and nasal mucosa.

The patient's nasal breathing will be uncomfortable for 3 to 4 days after surgery, then the swelling of the nasal mucosa will gradually decrease and nasal breathing will be restored.

One more important point postoperative course is the formation of “crusts” that complicate and interfere with nasal breathing. The so-called “crusts”, or if correctly, “fibrinous-necrotic plaque”, are formed 3–4 days after the operation, as a protective layer covering the operated area. At the same time, the nasal cavity needs careful toileting (cleaning), since this plaque tends to glue the mucous membrane of the operated inferior turbinate with the mucous membrane of the nasal septum. In this way, synechiae (adhesions) can form, which in turn will also need to be dissected, preventing the possibility of developing an adhesive process.

The ENT doctor performs/can perform nasal toileting daily or every other day, but only in the clinic sterile instruments. The patient will not be able to remove the “crusts” from the nose on his own due to their deep location and high adhesive ability. On average, a patient comes to the clinic after surgery for a nasal toilet 2–4 times. It all depends on the mechanisms of regeneration and the reparative ability of the human body.

It is possible to reliably assess the effect and quality of the ENT surgery performed only after a month, since only by this time the mucous membrane of the inferior nasal turbinates will be completely restored.


REDUCTION OF THE LOWER Nasal Conchae – This is an operation to improve nasal breathing.

REDUCTION OF THE LOWER Nasal Conchae is a painless radiofrequency effect on the submucosal structures of the inferior turbinates in order to reduce them and restore nasal breathing.

The most common diagnosis/condition for which REDUCTION OF THE INNER turbinates is performed is vasomotor/vasomotor-allergic/medicinal rhinitis in the vasodilation phase with an increase in the volume of the inferior nasal turbinates.

Radiofrequency exposure of the bipolar electrode causes excessive locally limited heating in the thickness of the cavernous/erectile tissue of the inferior turbinates, which in turn creates scar changes in it. For approximately 6 weeks after surgery, RADIO FREQUENCY REDUCTION results in a gradual reduction in the size of the inferior turbinates.

Typical possible but optional accompanying symptoms, complaints and conditions associated with the operation after returning home:

– Nasal tamponade. Rarely, there is a need for anterior nasal tamponade. In such a situation, you can remove them yourself a few hours at home after the operation, or you can come to the clinic again the next day and they will be removed by a doctor.

- PAIN. There may be some feeling of pressure and discomfort in the nose, itching, and nasal congestion after surgery. You can take painkillers/anti-inflammatory drugs (nimesil, paracetamol); drugs based on ibuprofen and aspirin are not recommended.

FIRST WEEKS AFTER SURGERY:

NOSAL DISCHARGE or small drops of blood from it are possible during the first 24–48 hours after surgery. You can start blowing your nose carefully after 5 – 7 days. When you blow your nose, the nasal discharge may be bloody and crusty. This can last up to 4 weeks. Vigorous/active nose blowing should be avoided as this may cause bleeding. A little fresh blood on a handkerchief, "spotting" on it is not a cause for concern even for up to several weeks after surgery. Don't worry, this is normal.

– DRY NOSE. Your nose may feel dry and stuffy for several weeks. Possible feeling severe runny nose. To relieve/eliminate this symptom, it is recommended to use the drug “Moreal plus spray” up to 6 times a day or more as needed. Vasoconstrictor drops (for example, “Afrin”) can be used only in case of sudden excessive difficulty in nasal breathing, without getting carried away with them.

– BLEEDING. If in postoperative period Have you noticed nosebleed, you can use any oxymetazoline-based vasoconstrictor drops (Afrin nasal spray, etc.), or moisten a cotton ball from a spray bottle and insert it into your nose for 15–20 minutes.

– Sit in a chair and relax. DO NOT lie down!!! – Close your nostrils tightly with your thumb and index finger. You can use ice - put it in a plastic bag, add a little water, press the bag tightly to your forehead and bridge of the nose. If bleeding continues long time(more than 30–45 minutes), despite the efforts made to stop it, if you begin to feel the condition worsening, call me or call an ambulance medical care, tell the EMS doctor that you have had reduction of the inferior turbinates.

PLEASE also call me if you have purulent nasal discharge and/or a temperature above 38 degrees 5 to 7 days after surgery.

PHYSICAL ACTIVITY. You can resume your normal activities if there are no signs of bleeding within 72 hours after surgery.

– Limit physical activity, lifting weights, visiting a fitness/gym for 2 - 3 weeks.

– Limit sexual relations up to 2 – 3 weeks.

– Avoid baths/saunas/hot baths/hot showers for the next 3-4 weeks after surgery as this increases the risk of bleeding.

– During the first 24 hours, it is advisable to sleep with your head elevated - this will help minimize the risk of bleeding, painful sensations and nasal congestion.

– Avoid bending your body and head down to lift things/tying shoelaces/digging with a shovel, etc. – this will help minimize the risk of bleeding.

FIRST MONTH AFTER OPERATION. Over the course of a month, your nasal breathing may not be ideal. You may experience mild, transient discomfort. In general, each day after surgery will be better than the previous one. Remember that your recovery is not the fastest process and largely depends on the regenerative capabilities of your body.

REDUCTION OF THE LOWER Nasal Conchae is effective in more than 85% of patients.

THE OPERATION IS AN OUTPATIENT SURGERY AND DOES NOT REQUIRE HOSPITALIZATION.

After the operation, you leave the clinic on the day of the intervention.

PREPARATION FOR OPERATION:

– You should NOT take painkillers/anti-inflammatory drugs (nurofen, aspirin, paracetamol, ibuprofen, etc.) for a week before surgery.

– For 3 days before surgery, be sure to use vasoconstrictor sprays in the nose at least 3 times a day.

FOOD AND DRINK BEFORE SURGERY

– You can and should eat well before surgery and drink sweet, non-alcoholic drinks (for example, weak tea with sugar). Don't come to surgery hungry!!!

SPECIAL PREPARATIONS

– If you are taking any medications on a regular basis, consult with your surgeon about the possibility of using them on the day of surgery.

OTHER MEDICAL PROBLEMS, RELATED DISEASES

– You are obliged to inform the operating ENT doctor about your heart problems, prolapse mitral valve if there are existing problems, problems with blood pressure, blood vessels, joints, kidneys, etc. This may be a reason to prescribe antibiotic therapy before the operation and even cancel the operation.

–For girls of fertile age: the operation is performed after the end of mensis, it is undesirable to perform the operation 3–5 days before the onset of mensis due to high risk postoperative bleeding.

ACTUAL OPERATION TIME usually does not exceed 15 – 30 minutes. Can be performed either under local anesthesia or general anesthesia.

ASSISTANCE WITH TRANSPORTATION AFTER SURGERY

– If the procedure is performed on an outpatient basis, then we strongly WE DO NOT RECOMMEND you to drive on the first day after surgery. Make sure you get a ride home. Don't use public transport.

OPERATION SCHEDULE.

– By e-mail or by phone, after interpreting the results of the tests you sent, you will be informed about the time and date of the procedure.

SHOULD I perform this surgery on myself?

No. You make the decision about the need for surgery. This is a palliative/optional surgery.

IS THERE AN ALTERNATIVE?

No, if a 2-3 month course of topical corticosteroid drugs did not help you. Vasoconstrictor drops and spray are not recommended for use for more than 2 weeks. If you use them for a longer period of time, the swelling of the nasal turbinates may be more pronounced.

WHAT WILL CHANGE AND WILL BE BETTER AFTER THE OPERATION?

Your nose will breathe better (over time) after surgery.

WHAT WILL NOT CHANGE AFTER THE OPERATION?

– All other symptoms (sneezing, itching in the nasal cavity, rhinorrhea, impaired sense of smell, etc.).

WHAT HAPPENS IF I DON'T HAVE THE OPERATION?

– Nasal breathing will remain inadequate. It may get worse.

WHAT ARE THE LONG-TERM PROSPECTS FOR THE OPERATION?

– In the vast majority of cases, normal nasal breathing can be guaranteed for decades after surgery; less often, swelling may return several years after surgery. Lifetime guarantees cannot be given.

WHAT DRUGS MAY BE NEEDED AFTER THE SURGERY?

– Moisturizing, anti-inflammatory and vasoconstrictor sprays, topical corticosteroid drugs.

WHAT CAN GO “WRONG” AND WHAT CAN BE DONE IN THIS CASE?

– Lack of adequate response to the anesthetic drug, pain during surgery. In this case, it is recommended to perform the operation under general anesthesia. The operation can be stopped at any time.

– Removal of excess tissue and formation of more crusts than usual. In this case, you may have to visit the clinic up to 2 – 4 times after surgery to monitor tissue regeneration and remove excess crusts in the nose.

WHAT SERIOUS COMPLICATIONS ARE POSSIBLE DURING ANESTHESIA AND SURGERY?

– There may be repeated bleeding, you may need nasal packing, you may need repeated intervention, even a blood transfusion. More serious complications extremely rare statistically. All surgical interventions And anesthesiological support have certain risks similar to everyday life and are comparable to flying on vacation, driving a car, etc.

WILL I HAVE BLACK CIRCLES UNDER MY EYES OR VISIBLE SCARS AFTER THE SURGERY?