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Nasal Turbinates

What are nasal turbinates and how do enlarged nasal turbinates cause problems?

The turbinates are sausage shaped structures made of thin bone covered by spongy mucous membranes in the nasal cavities. There are three on each side and are called the superior, middle and inferior turbinates. The turbinates have three main functions. They warm the air we breathe, humidify this air as it passes through the nose, and the mucous layer of the turbinates assist in filtering particles such as dust and pollen.

The turbinates, particularly the inferior, can block breathing when they are enlarged. The inferior turbinates are most commonly enlarged by swelling of the mucous membranes caused by allergies. This enlargement is due to increased blood flow into the tissue which then are congested. The middle turbinates can be enlarged if an air-bubble develops inside the bone, a condition called concha bullosa. Concha bullosa of the middle turbinates may narrow the space through which the sinuses drain, the ostiomeatal complex, and hence can contribute to sinusitis.

When should I see a doctor for sinusitis?

When a cold or sinus symptoms persist beyond a week, it is time to see a physician. Most viral infections will resolve or at least significantly improve during that time. Acute sinusitis is readily treatable by antibiotics and if it is suspected, should be treated to prevent the complications that may develop from a sinus infection. Symptoms that may suspect an emergency situation include significant swelling around the eye, headaches that won't go away with over-the-counter pain pills and difficulty with vision or concentration. These may be suggestive of a sinus infection that has extended out into the eye or brain tissues.

What type of doctor should I see for sinusitis?

The first provider that should be consulted is often a primary care doctor, nurse or physician assistant. These are often practice in pediatrics, internal medicine or family medicine. These providers see and manage the majority of sinus infections that develop. If sinus infections occur repeatedly, your primary care provider may refer you to an otolaryngologist, an ENT (Ear Nose Throat) physician, for further evaluation. Additionally, if the primary care physician feels that allergies are a contributing factor, he or she may refer the patient to an allergy specialist. An allergist is an internal medicine physician who has completed additional training in the areas of allergy, immunology and asthma.

If you suspect that that the symptoms are urgent you should be seen at an emergency room or urgent care clinic. Sinus infections are in the head and there are a lot of surrounding structures that can be affected if an infection gets out of control.

Content courtesy of AAO American Academy of Otolaryngology

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