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The truth about turbinates (and sinusitis)
- blamestross 5y agoWhelp, my chance to shine. I had my turbinates surgically removed as part of sinus reconstruction. About a year after I got my face smashed really well. Reading the surgery notes later I found out the surgeon gave me cocaine! This is apparently old fashioned but normal. The biggest consequence is that in the nostril that isn't blocked by my bowed septum, I can stick my finger a lot further up. Ask me anything!
- GDC7 5y agotape your mouth during sleep
- adflux 5y agoThis... Its so wierd, but it improves my sleep. I dream more vividly aswell...
- Traubenfuchs 5y agoDear diary, today hacker news made me tape my mouth shut before sleep. How am I gonna explain this to my partner? If it stops me from snoring and him from kicking me, that‘s a win for both of us though.
- toast0 5y agoI suggest "Hey partner, my weird internet friends told me if I tape my mouth shut while I sleep, it might help with snoring and improve my quality of sleep, so I'm going to try it, let me know if it works" and if your partner is snarky, be prepared with eye rolls for him to say "why only at night?" One of my neighbors recommended thiamine supplements for help with night breathing, and my spouse was happy to have me try something. I'm sure she'd be happy to have me try taping my mouth shut overnight too. I had some success with the thiamine, but the first suppliment pill is a B-complex with lots of stuff (all at pretty high RDA %s) and something in there makes my muscles ache in addition to seeming to help with night breathing and smelling like a vitamine shop. I've now got a liquid I'm supposed to dropper into my mouth, but it tastes and smells like a vitamin shop, which is hard for me to tolerate, and it doesn't seem to work as well (lower dosage and as bottle has been used, the dropper isn't so full). The first couple or times I used it, I noticed when waking up that I was breathing through my nose and it felt easy; that's not normal for me, I can breathe through my nose, but it usually takes some amount of concious effort to do so.
- drBonkers 5y agowhat tape do you use?
- vakili 5y ago3M Micropore Surgical Tape.
- elric 5y agoLet me just chime in here, because while often a good idea, your comment is a little sparse, and this is an idea that can weird people out. Background: I was diagnosed with obstructive sleep apnea some years ago, and I've been sleeping with a CPAP device ever since. In general, CPAP follow-up and compliance rates are pretty terrible. Thankfully there's a very helpful community out there to help people with their various issues (reddit, apnea board, etc). I've basically tried everything and I've spoken to countless of people in the same boat. I'm just a guy on the internet, so take what I'm saying with a generous pinch of salt. One of the most common issues with snorers and apnics (is that a word?) alike, is that things get worse when the mouth is open. When you're on nasal CPAP, opening your mouth will cause a lot of the air to simply blow out your mouth, which will reduce your effective therapeutic pressure (i.e., CPAP is now practically useless). If you're using a full face mask, an open mouth can reduce the fit of the mask, allowing escape, usually near the chin. This, too, can result in a drop in pressure, though usually not as dramatic as with a nasal mask. There are basically zero good ways of preventing your mouth from opening at night. It happens to some people, not to others. No clue why. If it happens to you, nearly every "solution" sucks. Chin straps don't work, they will make your apnea worse by pulling your jaw into your airway, exactly where it's not supposed to be. Cervical collars are incredibly uncomfortable for sleeping. Mouthguards (like the kinds boxers use) are really uncomfortable for some people, but some people seem to tolerate them well enough. On to the tape: there's only one reason to use it: to keep your mouth shut at night. Mouth breathing = bad. Especially when on nasal CPAP. Use a low-stick tape that's skin safe. I use a piece roughly the size of a Charlie Chaplin moustache. That's wide enough to keep my mouth shut, and narrow enough so that I can still breathe out of the corners of my mouth if I really have to. I do occasionally suffer a corner-of mouth-leak, but as it's a narrow gap, the CPAP machine can easily cope. A word on aspirating vomit, as this seems to be a common concern. If you suffer from awful reflux, or are just unlucky enough to have to throw up while asleep, you're going to be having a bad time. Regardless of anything else. If you're on CPAP, there's a chance the pressure will be sending bits of goop down your airway. This is bad. If you're wearing a mouthguard, this will be worse. If you've taped your mouth, this too could make things worse. I once had threw up while on CPAP and mouth tape. Nothing bad happened, when the process started, it startled me and woke me up, I instinctively removed the tape and the CPAP mask before the vomit reached my mouth. Not fun, but no damage either.
- PostThisTooFast 5y agoEven if we accept this article's assertions, it doesn't say what the solution is AFTER vacuum-induced damage has occurred. And the primary assertion, that your turbinates are damaged by vacuum induced in your nose when you breathe through your mouth, doesn't make sense. If you're breathing through your mouth, what causes vacuum in your nose? It's being bypassed. Try it yourself.
- sendomatic 5y agoMy nose is almost permanently running or clogged. Eventually I went to see an ENT who sent me for a scan and was surprised to find that I didn't have an inferior turbinate on one side. When I was younger I smashed my nose and had surgery so either that doctor removed the inferior turbinate during that surgery or I was just born without one. Either way it seems to have left me in a snotty situation.
- klipt 5y agoSeems obvious that a structure present in pretty much ALL humans has some evolved purpose. If you want to scare yourself, search for "empty nose syndrome" and you'll find horror stories of people feeling like something is horribly wrong after surgeons removed their turbinates (often without telling them, while doing another procedure like deviated septum) ... some even end up committing suicide. Chesterton's Fence comes to mind: > The more modern type of reformer goes gaily up to it and says, “I don’t see the use of this; let us clear it away.” To which the more intelligent type of reformer will do well to answer: “If you don’t see the use of it, I certainly won’t let you clear it away. Go away and think. Then, when you can come back and tell me that you do see the use of it, I may allow you to destroy it.”
- s5300 5y agoCame here to talk about empty nose syndrome. If you have any sort of general hypersensitivity or touch disorders, don’t let anybody ever touch your turbinates. You’ll likely go mad. Note: this isn’t saying the only people to get ENS are those with a hypersensitivity/similar disorder
- msla 5y ago> Seems obvious that a structure present in pretty much ALL humans has some evolved purpose. Contrast with the length of the recurrent laryngeal nerve: https://en.wikipedia.org/wiki/Recurrent_laryngeal_nerve https://en.wikipedia.org/wiki/Recurrent_laryngeal_nerve > The extreme detour of the recurrent laryngeal nerves, about 4.6 metres (15 ft) in the case of giraffes,[27]: 74–75 is cited as evidence of evolution, as opposed to Intelligent Design. The nerve's route would have been direct in the fish-like ancestors of modern tetrapods, traveling from the brain, past the heart, to the gills (as it does in modern fish). Over the course of evolution, as the neck extended and the heart became lower in the body, the laryngeal nerve was caught on the wrong side of the heart. Natural selection gradually lengthened the nerve by tiny increments to accommodate, resulting in the circuitous route now observed.[28]: 360–362 Imagine how long the nerve must have been in long-necked sauropods: https://bioone.org/journals/acta-palaeontologica-polonica/volume-57/issue-2/app.2011.0019/A-Monument-of-Inefficiency--The-Presumed-Course-of-the/10.4202/app.2011.0019.full https://bioone.org/journals/acta-palaeontologica-polonica/vo... > The course of the recurrent laryngeal nerve appears to be an unchanging aspect of tetrapod embryology, being as developmentally fixed as the presence of a heart and paired vessels to the head. The existence of 28 m neurons in the RLN of Supersaurus may seem fantastic, but they appear unavoidable given what we know of tetrapod embryology and evolution. Other neurons in the bodies of sauropods were even longer, spanning the entire distance from the brainstem to the tip of the tail, and may have been the longest cells in the history of life. These incredible cells represent the interplay of evolutionary innovation and developmental constraint: the acquisition of giant, long-necked and long-tailed bodies built on a deeply conserved tetrapod bauplan.
- colechristensen 5y agoI wonder how much this has to do with humans rarely needing to chew tough food any more (weakening the jaw, causing the mouth to open in sleep) I had a lot of these problems growing up.
- silisili 5y agoAs a data point of one, my guess would be not much. I've had sinus problems and turbinate surgery. As a kid, and even as an adult, I have a weird chewing fixation. As a kid it was wet rags for some reason, as an adult pen caps and the like. And not like nibbling nervously, I'm talking chewing with molars into an unrecognizable mess. Jaws are super strong, sinuses suck.
- Empact 5y agoAnyone interested in following this line of thinking should look into Orthotropics[1] and Mike Mew.[2] A key insight is that bones are modeled not only according to a genetic program, but also in response to pressure - they move so as not to clash with one another, and reinforce themselves to deal with more demanding environments / greater pressures. Personally I grew up with difficulty breathing through my nose, and didn't realize until my 30s that I had an undiagnosed tongue tie[3]. I've been applying orthotropic practices for several years and now breathe easily through my nose. [1] https://reddit.com/r/orthotropics/ https://reddit.com/r/orthotropics/ [2] https://www.youtube.com/watch?v=TY3bIMRKil8 https://www.youtube.com/watch?v=TY3bIMRKil8 [3] It was noted a few times over my life by dentists, but in the form of noticing the symptoms of the issue, such as a tongue thrust swallowing pattern. In my case, my breathing was restricted, but an ENT could not see why - my best guess as to why was that my airway was constricted front to back (ventral to dorsal).
- alfor 5y agoIf you like this reasoning absolutely read: A Hunter-Gatherer's Guide to the 21st Century https://www.amazon.com/Hunter-Gatherers-Guide-21st-Century-Challenges/dp/0593086880 https://www.amazon.com/Hunter-Gatherers-Guide-21st-Century-C... There is so much knowledge about how our modern world is causing much of our health problems. Wisdom teeth: food to soft Myopia: not enough exposure to UV light while growing Whe should know these things way before we think of medication and chirurgy. And yes, use science and technology to improve our lives when appropriate.
- flreln 5y agoThanks!
- gameswithgo 5y agoSome of those things are very speculative.
- seehafer 5y agoI had turbinate reduction after a series of never-ending sinus infections. Lessened the symptoms somewhat, didn't abate. Went to an allergist, found out I was allergic to pretty much everything outside, went on immunotherapy for 5 years, haven't had a sinus infection yet. Best thing I ever did for my health. Moral of the story: Surgeons like to do procedures. ENTs are surgeons. Act accordingly.
- dinkleberg 5y agoThanks for sharing your experience, you've inspired me to go find an allergist. I'm tired of feeling like crap for months every spring.
- emptysongglass 5y agoI have sinusitis. Been tested twice by two different ENTs for a common allergy screening. Nothing. Should I be doing something different?
- seehafer 5y agoYMMV of course. Did you get skin and blood testing? I've found that dedicated allergists tend to be more thorough about this, but there's no guarantee that allergies are the cause of your sinusitis.
- eterm 5y agoWhat do you mean by immunotherapy?
- elric 5y agoNot the person you're replying to, but probably allergen immunotherapy, aka desensitization. Basically you're given ever increasing doses of whatever it is you're allergic to. Over time, you should build up a tolerance. IIRC there are tablets available for common allergens like dust mites. For others, you need to get regular shots, which is a bit tricker and riskier.
- cryptonector 5y agoI had something of a turbinate reduction surgery. More like a liposuction of the turbinate than a resection. The surgeon said it would be life-altering. It was, and it was a very good life alteration.
- jkmcf 5y agoI had this done 15 years ago. For a few weeks it was life changing, then the proble, nostril went right back to 95% clogged. This is supposedly typical, but I’m sure YMMV. Glad yours didn’t regress!
- cryptonector 5y agoI had a lavage and deviated septum correction at the same time. The lavage was probably essential.
- AlbertCory 5y agoI had a horrendous sinus infection in 2006, and got Prednisone for it, and various other drugs, and finally it went away. Fortunately, my allergy test didn't indicate much in the way of allergies. Before that, I had regular bouts of cold-like symptoms, was on Claritin, etc. etc. Then I heard something which (cliché alert!) changed my life: it's sinus-rinsing. I discovered that it's not some woo-woo alternative therapy; lots of people do it, and your doctor will probably give it his or her blessing. You can get the kits in any drugstore (I use NeilMed). Everyone hears "sinus rinsing" and says "Neti Pot" and that's fine, although I think its major advantage is its Eastern-sounding name. I just use the squeeze bottle. Be sure to use distilled water. The powder is just saline and baking soda, which makes it not burn the inside of your nose. Since I started this, I get maybe one cold a year, and it goes away in a week and a half or so. What's the technical, scientific explanation for this? "It clears the crap out of your nose" pretty well covers it.
- germinalphrase 5y agoIs there a reason for distilled water over, say, an in home RO? I always assumed it was to avoid potential bacteria, amoebas, etc.
- AlbertCory 5y agoI'm not particularly paranoid, but I do notice mineral buildup over time from tap water. In fact, my dishwasher may be end-of-life because of it. (and of course, as others have said, bacteria, amoeba, disinfecting chemicals, minerals from the house's pipes... did I mention that I'm not paranoid? :) :) ) But YMMV -- if you're happy with reverse osmosis, go for it.
- QuercusMax 5y agoDo you ever run a descaling cycle? You can use citric acid or a cleaning pack that's basically just Citric acid.
- AlbertCory 5y ago
- ortusdux 5y agoOnly one data point, but I know someone that had radio-frequency turbinate reduction. They were suffering from constant sinus pressure and migraines that correlated with sudden changes in barometric pressure. An MRI revealed abnormally large turbinates. As far as procedures go, the RF reduction was very mild with minimal post-op. Their doctor errors on the side of caution, preferring to start small with the treatment and repeating the procedure if necessary. The first treatment worked wonders, greatly increasing QOL and nearly eliminating the migraines. It's been over a year and my friend is still very happy with the results.
- SilasX 5y agoYeah I’m perplexed because that matches my experience despite the article saying I should be doomed from this course of action. I had a problem where if I tried to breathe in deeply, especially while exercising, my nostrils would choke off and I couldn’t suck in air through my nose. My primary care doctor said I had a deviated septum and sent me to an ENT, who agreed but said it was minor and my real problem was turbinate hypertrophy. After a painful and bloody operation (with the RF) and a week of healing, I can be easily breathe through my nose, and this was over three years ago and I haven’t noticed anything else changing, so this is diametrically opposite all the doom and gloom. The ENT was a dick in other ways though.
- gameswithgo 5y agoFor those that have actual turbinate obstructions like I have had, there is a new drug that can prevent their regrowth, Dupixent. Something to look into if you have failed to control this problem. It can also relieve mild asthma symptoms, so for me it was kind of a 2 for 1 As well, there is a new kind of allergy shot you can get now, where you get the injections directly into lymph nodes, and they last for 3-5 years rather than needing shots weekly etc.
- bickfordb 5y agoAnecdotally, I had a deviated septum correction and turbinate reduction (not complete removal.. I think they were cauterized down?) surgery last spring. It was mildly uncomfortable for a day or two after the surgery. Before the surgery I was a chronic snorer and couldn't breathe through solely my nose when running/cycling. I would get awful daily sinus headaches that would make it really difficult to focus on coding. I now no longer snore at all and can breathe through my nose all the time and am a lot more comfortable during aerobic exercise and my headaches are mostly gone. I still use antihistamines and sinus rinses to keep the rear part of my sinuses from bothering me.
- pizza234 5y agoAnecdata as well: I had similar conditions, procedure, and outcome. Unfortunately though, my nose worsened (got progressively stuck again) in the few subsequent years, although, better than it was before surgery.
- bedobi 5y ago> Obviously, #1 (True obstruction) can be fixed if the obstruction is relieved, and that is another topic for another day Uuuhh I would very much like to know what the author would suggest
- gameswithgo 5y agoyou cut em out
- bedobi 5y agono, that's exactly what the author is saying NOT to do
- aantix 5y agoRinsing with baby shampoo is the only thing that has ever long term helped my sinus inflammation. It’s been amazing. https://www.nysinuscenter.com/2015/08/baby-shampoo-for-your-sinuses/amp/ https://www.nysinuscenter.com/2015/08/baby-shampoo-for-your-...
- jeramey 5y agoI’d never heard of this, so thank you! I’m not very excited by the prospect of surgery, and all of the other “treatments” I’ve been recommended are steeped deeply in woo, or pretty obviously a bad idea, or both. (E.g. colloidal silver.) A little web searching even turns up an NIH study. The abstract indicates promising results with the only likely downside being a possible case of minor irritation. https://pubmed.ncbi.nlm.nih.gov/18284857/ https://pubmed.ncbi.nlm.nih.gov/18284857/
- aantix 5y agoThere’s much less precision to my method. I use this irrigation bottle. https://www.amazon.com/Neilmed-Sinus-Rinse-Starter-packets/dp/B000RJGB5C/ https://www.amazon.com/Neilmed-Sinus-Rinse-Starter-packets/d... A drop of J&J shampoo. I rinse both nostrils while in the shower. Burns slightly. But after about a day, the irritation goes away and my sinuses feel much better. I use to do this much more frequently, daily, but after a couple of weeks, I found it’s no longer needed as much.
- xbar 5y agoAll I see is Gravity's Rainbow. Am I alone?
- VirusNewbie 5y agoIt almost seems like according to this doctor, Oxymetazoline would be an acceptable treatment (as in, allow someone to get used to nose breathing at night for a long period of time). I did have turbinate reduction recently, and it definitely gave me an improvement, but only about 30% I'd say. I no longer have 100% blocked nasal passages during the day, which I would during allergy season previously. I have been using Oxymetazoline regularly, but I give myself a much smaller dose. Before nose spray and the procedure, in my case I would go to sleep with a partially clogged nose, and wake up with a fully clogged nose after a few hours. It was terrible, i'd have dreams of drowning and wake up gasping for breath. I sleep much better now. I don't experience a 'rebound affect' either.
- DantesKite 5y agoFor anybody who has had chronic sinus infections, I have some advice: Try rubbing kimchi juice inside your nostrils. The bacteria colonizes the nose well. This is coming from someone who has a humidifier, did nasal rinses, bought various menthols products to rinse nose, stayed in a room with 99% humidity for hours a day, took antibiotics, sprayed xylitol nasal spray, took lozenge probiotics. Barely made a dent. The bacteria found in kimchi seems to slowly spread deeper and deeper into your nasal cavity. I don’t want to hypothesize too much on why it works. I’ve discovered that most of the time we really don’t understand the causal mechanisms. And even if we do, years later the explanation changes. I’ll just simply say a lot of people have suffered from chronic sinus infections and have found relief from this route. But if kimchi juice isn’t your thing, you can order the actual probiotic online. Just search “sinus infection probiotic”. If you do decide to use kimchi, make sure it has garlic and doesn’t have vinegar. The garlic promotes the growth of the specific bacteria you need while the vinegar destroys it.
- swsieber 5y agoHa. I had the thought the other day that if fecal transplants are effective then maybe snot transplants would be too. Not exactly the same, but it is in the same realm.
- joeman1000 5y agoThis would have been great to read about before I had surgery. I had septo-rhinoplasty and turbinate reduction last year to help sleep apnoea. It was recommended by a sleep specialist who noted my nasal passages were ‘very small’. It was also recommended by two separate surgeons. It was still very hard for me to trust the surgeons, since there is a conflict of interest. Overall I was able to breathe freely through my nose for about a month and then the effect slowly wore off. Overall it is better but not life-changing or worth the gross pain and bleeding from surgery. My nose is still tender and aching a year later. I think the article is spot-on. I always have a creeping feeling when doctors recommend surgery, as they make lots of money from cutting me open and the benefits may be dubious. I will try what this article recommends: trying to direct air through my nose at night.
- aakresearch 5y agoA few years ago I experienced an episode of debilitating sinus pain, although generally my breathing was not obstructed. After a year of misery I was referred to some ENT surgeon. 30 seconds into consultation, after glancing at X-rays the doctor started pushing a surgery because, apparently, my mid-nasal cartilage wasn't looking straight enough for him. When I asked if it would help my sinus pain the answer was "maybe, but unlikely", but "just sign here and we'll start preparation for the operation; it is mostly covered by Medicare!". Fair to say, that consultation didn't last too long. I haven't seen any other doctor after, and the pain subsided and was completely gone in 6 months or so.
- joeman1000 5y agoIt is so blood-boiling that someone would push another person into potentially debilitating surgery just to make some money. I had a surgeon holding the pen on the consent forms and he had barely even told me what he would do. I felt sick, as I realised it was just a way to catch me off guard and not let me think about the decision.
- ahwvd37js 5y agoI had turbinate reduction and deviated septum repair surgery and it changed my life for the better. I sleep better, wake up more refreshed, and have more energy during the day.