Current treatments for chronic nasal congestion range from behavioral changes (i.e., avoiding exposure to the triggers that cause rhinitis) to invasive surgery. While avoidance of irritants in the environment is a key factor in managing chronic rhinitis, such lifestyle changes can be difficult. Medical therapy offers only temporary relief of chronic nasal obstruction due to enlarged turbinates, but it can also be associated with significant side effects. Surgical treatments can be associated with lengthy recovery periods and significant post-operative discomfort.
Medications designed to treat congestion, sinus complaints and the common cold make up the largest segment of the over-the-counter drug market for the U.S. pharmaceutical industry. First-line medical treatment for the chronic stuffy nose and chronically enlarged turbinates associated with rhinitis mainly consists of a variety of antihistamines, decongestants, and topical and systemic corticosteroids. These drugs provide only symptomatic improvement; they cannot cure the condition. Immunotherapy, or injections of allergens, can offer moderate help to some people with severe allergic rhinitis.
Surgical treatment of enlarged turbinates that cause chronic nasal obstruction is indicated only after patients fail to respond to medical therapy. Turbinate surgery can be performed as an office procedure under local anesthesia or in the operating room under general anesthesia. Laser, electrosurgical, or standard excision methods may be used. (See Standard Surgeries for Nasal Obstruction)
A minimally-invasive radiofrequency technique pioneered by Columbia Presbyterian physicians is now being widely used to treat patients with chronic nasal obstruction due to enlarged turbinates. Somnoplasty entails the use of a precise radiofrequency probe to target the nasal tissue and shrink its volume. After several treatments, tissue volume is decreased by approximately one fifth to one third, easing the airway obstruction and allowing for much improved breathing. Post-operative pain is minimal, no nasal packing is required, and patients may resume normal activities immediately.