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Practice Update

Dr. Hernan Goldsztein is now a full partner with Pacific ENT Medical Group, Inc.

Dr. Hernan Goldsztein was selected as a Top Doctor in Otolaryngology by his peers in 2017 and 2018 as featured in San Diego Magazine.

Dr. Moses Salgado and Dr. Hernan Goldsztein were featured as “Champions for Health” in San Diego Physician Magazine because of their volunteer work with patients in Project Access San Diego

Pacific ENT of San Diego County's Carlsbad * Treating Sinusitis * Sinus Surgery * Sleep *  Snoring * Sleep Apnea * Allergies * Ear Hearing & Balance * Voice * Head & Neck Surgical Care Allergist ENT Sinus Doctors of San Diego County California

Turbinate Surgery (Endoscopic Sinus Surgery)

Protruding into each breathing passage are bony projections called turbinates that increase the surface area of the inside of the nose. The turbinate functions to humidify the air, it shrinks and swells to regulate nasal air resistance, and it collects airborne particles on its surface to clean the air. There are three turbinates (inferior, middle, and superior) on each side of the nose.

Large, swollen inferior turbinates can lead to blockage of nasal breathing. There are two main reasons for enlargement. Most of the time, enlarged inferior turbinates are the result of allergies, irritating environmental exposure, or some minor persistent inflammation within the sinuses. Another reason long standing septal deviations that allow the inferior turbinate to enlarge on the concave side of the deviation.

In the case of allergy, or irritant-related enlargement, treatment of the underlying problem may reduce turbinate swelling and solve the problem. Medical treatment may include use of decongestants, antihistamines and intranasal steroid sprays. Other allergy treatment such as immunotherapy (shots) may be recommended.

If the turbinates remain enlarged despite medical therapy, turbinate reduction surgery may be required. Because the turbinates help the nose to clean and humidify the air we breathe, it is usually better to leave as much tissue intact as possible. The doctor will probably opt for selective, or targeted, turbinate reduction, rather than extensive reduction.

If the procedure is isolated, and not part of another sinus operation, reduction of the inferior turbinate is usually performed under local anesthesia. Sometimes, surgery is guided by a headlight, but increasingly, surgeons use endoscopes to improve visualization and provide a magnified view during surgery. Once oriented, the surgeon makes an incision in the lining mucosa of the turbinate and carefully

removes the underlying bone of the turbinate. If selective removal of soft tissue is also necessary, it can be accomplished using cautery or radio frequency electrical current, laser or a microdebrider.

Complications associated with inferior turbinate surgery include bleeding, crusting, dryness, and scarring. If you undergo an inferior turbinate reduction, your doctor may prescribe a spray or watery solution to relieve dryness and aid in healing.

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