Shaver conchotomy

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Conchotomy: when performed, methods, course of surgery, rehabilitation

Conchotomy is an operation whose purpose is resection (partial or complete removal) of pathologically enlarged nasal turbinates. It is one of the types of operations to restore normal nasal breathing.

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The turbinates are bony projections in the lateral wall of the nose, covered with mucous membrane. By increasing the surface area of ​​the mucous membrane, the turbinates help perform the primary function of the nose: warming, moisturizing, and purifying the air we inhale. The area of ​​the inferior and middle turbinates contains cavernous tissue, which also plays a protective role: when very cold or very polluted air enters, this tissue increases in size, and the nasal passages narrow.

structure of the nasal turbinates

Why do turbinates sometimes need to be removed?

The nasal turbinates are not at all superfluous structures in our body, but sometimes they can cause persistent disruption of nasal breathing, as well as various other chronic pathologies.

The main reason for conchotomy is hypertrophic rhinitis, that is, excessive growth of the turbinates to such an extent that they completely block the nasal passage and free breathing through the nose becomes impossible.

Hypertrophy of the nasal concha occurs:

  • In case of chronic inflammation of the nasal mucosa.
  • With a deformed nasal septum (compensatory hypertrophy).
  • For long-term vasomotor rhinitis.

In this case, both the mucous membrane and the periosteum and bone of the nasal turbinates undergo hypertrophy.

Hyperplasia can be diffuse and focal (only the anterior or only the posterior ends of the shells can be hypertrophied).

In the initial stages, hypertrophic rhinitis is quite amenable to conservative methods.

In cases of moderate severity, it is possible to use various minimally invasive procedures (cauterization of the mucous membrane with sclerosing substances, electrocoagulation, cryodestruction, ultrasound and mechanical vasotomy of cavernous tissue).

In cases of true hypertrophy, when not only the mucous membrane is involved in the process, but also the bone structure, surgical intervention may be necessary.

Difficulty in nasal breathing not only reduces the quality of life, but also causes a number of complications.

In the vast majority of cases, the inferior nasal concha is resected, less often the middle one.

Main indications for conchotomy

  1. Persistent long-term impairment of nasal breathing.
  2. Chronic sinusitis caused by a violation of the outflow from the sinus due to the blocking of the natural anastomosis by an enlarged nasal concha.
  3. Chronic otitis or tubo-otitis, the cause of which is a violation of the outflow from the auditory tube.
  4. One of the stages of rhinoplasty is surgery to correct the shape of the nose.

Basic principles of conchotomy

  • The operation should be as gentle as possible. It is very rare that the entire shell needs to be removed. Basically, only part of it is removed, the anterior or posterior end (sparing conchotomy).
  • The operation should be low-traumatic, using modern equipment and gentle microsurgical instruments.
  • Preference is given to submucosal resections (submucosal osteoconchotomy).
  • Usually combined with other interventions in the nasal cavity (correction of a deviated nasal septum, sanitization of the paranasal sinus, removal of polyps).

Main types of conchotomy

sparing lower conchotomy

By volume of intervention:

  1. Sparing anterior conchotomy (removal of the anterior end of the shell).
  2. Gentle posterior conchotomy.
  3. Bilateral inferior conchotomy.
  4. Submucosal conchotomy.
  5. High resection of the middle turbinate.
  6. Conchectomy - removal of the entire nasal concha along with the bone.

According to the methods of carrying out the conchotomy, it can be:

  • Conchotomy using cutting instruments.
  • Shaver endoscopic conchotomy.
  • Laser conchotomy.
  • Radio wave method.

Examination before conchotomy

In addition to the usual preoperative examination (blood tests, urine tests, blood clotting, biochemical analysis, ECG, testing of antibodies to hepatitis, HIV, syphilis, fluorography), a special examination is also carried out by an otolaryngologist:

  1. Endoscopic examination of the nasal cavity to clarify the extent of damage. Helps to identify the most hypertrophied areas and determine the extent of the operation.
  2. X-ray of the nasal cavity and paranasal sinuses.
  3. If necessary, computed tomography of the paranasal sinuses.

Contraindications for surgery

The operation is not performed in the following cases:

  • Acute infectious diseases.
  • Acute inflammatory processes in the nasal cavity (surgery is possible after conservative treatment).
  • Hemophilia and other blood clotting disorders.
  • Decompensation of chronic diseases of the heart, liver, kidneys, endocrine organs.
  • Pregnancy.
  • Epilepsy.

Progress of the conchotomy operation

The operation is performed mainly under general anesthesia, but local anesthesia with premedication can also be used. Typically requires hospital stay.

The patient's position is supine. The mucous membrane in the nose is first lubricated with local anesthetics, and then solutions of novocaine, lidocaine, ultracaine or articaine are infiltrated into the mucous membrane.

Instruments for conchotomy: nasal cutting loop, as well as turbinate scissors.

A clamp is applied at the border of the excised area for several minutes to reduce bleeding. After removing the clamp (and sometimes without removing it), the shell is directly removed. Removal is done with scissors, moving them from front to back, or with a nasal loop. But more often it is a combined use of these tools: an incision is made with scissors, then complete removal using a cutting loop.

Submucosal osteoconchotomy

It is performed when the predominantly bony component of the shell undergoes hyperplasia in a relatively normal state of the mucous membrane. The essence of the operation is that an incision is made in the mucous membrane in the area of ​​the lower concha, the mucous membrane is separated from the underlying tissues.

Using bone cutters, the bone is resected, the mucous membrane is placed in place and pressed with a tampon.

Conchectomy

The entire nasal concha is removed when the nasal passage is very narrow, or when after examination it becomes clear that gentle resection will not give positive results.

The indications for such an operation must be very strict; in case of severe atrophy of the mucous membrane, it is not performed. It is also contraindicated for children under 14 years of age.

Removal of the nasal concha along with its bone base is performed using Struycken forceps; the concha is cut to the base, moving the instrument from front to back.

After operation

The operation lasts about an hour.

Immediately after removal of the turbinate, a gauze turunda soaked in a hemostatic agent and lubricated with an indifferent ointment is inserted into the nose.

The tampon is usually removed after 24 hours; removing the tampon can be quite painful. There are gel tampons with air ducts inside, their use is much more comfortable.

After surgery, antibiotics and painkillers are usually prescribed.

The patient remains in the hospital for several days, then, if there are no complications, he can be sent home.

Over the course of several days, blood crusts will form in the nose, and increased mucous discharge will be observed for some time.

Oil drops are prescribed to be instilled into the nose, after a few days you can rinse the nose with saline solution.

For 2 weeks, it is not recommended to stay in high temperatures, eat hot and spicy food, or perform heavy physical work.

Final healing occurs in 2-3 weeks, and by this time normalization of nasal breathing usually occurs.

To restore nasal breathing, special breathing exercises are recommended. Sometimes the patient has to relearn how to breathe through his nose.

Modern methods of conchotomy

Conchotomy with a nasal loop and conchotome has its disadvantages:

  1. Highly traumatic, high risk of bleeding.
  2. Long rehabilitation period and discomfort after surgery.
  3. Risk of formation of adhesions.

There are many more modern ways to perform this operation: conchotomy using an endoscope and shaver, radio wave and laser conchotomy.

Shaver conchotomy under endovision control

This method refers to modern methods of surgical treatment of hypertrophic rhinitis. It is carried out using endoscopic technology, the image is visible on the screen in a greatly enlarged size.

A shaver is a tool that consists of a tip with a rotating blade connected to a suction device. The blade, as it were, “shaves off” the tissue to be removed, crushes it, and with the help of suction it is immediately removed.

Using this method, it is possible to perform both gentle anterior or posterior conchotomy and submucosal resection.

This method is less traumatic compared to the classical one, and the rehabilitation period takes less time.

Video: endoscopic shaver conchotomy

Laser conchotomy

Laser radiation has been successfully used in medicine for a long time. It can be easily focused to the desired location, with minimal risk of damage to surrounding tissue. With the help of a laser, tissues are “evaporated,” as it were, thereby achieving the main goal of any operation - removing unnecessary areas.

Laser removal of overgrown turbinate tissue is becoming increasingly popular. This has its own explanation:

  • Laser conchotomy can be performed on an outpatient basis under local anesthesia.
  • The laser coagulates the vessels, and after such exposure there is practically no bleeding.
  • The laser has antiseptic properties and the risk of infectious complications is minimal.
  • The rehabilitation period is several days.
According to reviews from patients who underwent laser conchotomy, they experienced virtually no discomfort after the operation. Even intranasal swabs were not required. Breathing is restored after 2-3 days.

If a bilateral conchotomy is to be performed, it is better to perform it using the laser method.

Video: laser destruction of turbinates

Radio wave surgery of turbinates

Removal of excess areas of mucous membrane is performed with a loop to which a high-frequency current is applied using the Surgitron apparatus. This operation takes place almost without blood and without pain, and can be performed on an outpatient basis. The recovery period is 3-5 days.

Complications after conchotomy

  1. In the early postoperative period there is bleeding.
  2. Purulent inflammations – rhinitis, sinusitis, otitis media.
  3. Formation of adhesions and adhesions in the nasal cavity.
  4. Nasal deformities (rare).
  5. Development of atrophic rhinitis.
  6. Relapse of pathology.

Main conclusions

Let's summarize the main results:

  • Hypertrophy of the nasal turbinates is a fairly common cause of difficulty in nasal breathing; conservative methods are ineffective, and at a certain stage in the development of this pathology, the need for surgery arises.
  • With the correct indications, conchotomy gives quite satisfactory results. Patient reviews are mostly positive. The quality of life improves.
  • In practice, there are quite a few methods of conchotomy, but not one is the “gold standard”. The choice of method depends on the preferences of the doctor and the patient, capabilities, including financial ones.
  • After any of the conchotomy methods, relapse is not excluded - the formation of granulations and new tissue growth.
  • To reduce the risk of relapse, it is recommended to completely avoid vasoconstrictor drops, be examined and treated by an allergist, and regularly monitored by an otolaryngologist.

Source: http://operaciya.info/uhogorlonos/konxotomiya/

Conchotomy of the nasal turbinates

Conchotomy is a resection or surgical reduction of the turbinates, in which the hypertrophied mucous membrane (sometimes together with fibrous and polypous growths, bone tissue of the lower and middle turbinates) is surgically removed to improve nasal breathing.

Conchotomy of the nasal turbinates is one of the methods of forced removal of pathologically overgrown mucosa. It is used primarily when conservative treatment is ineffective and the use of more gentle surgical interventions on the nasal turbinates is inappropriate.

Functions of the nasal turbinates and pathological changes during their tissue hypertrophy

The nasal turbinates perform important physiological functions:

  • regulate the volume of incoming air;
  • moisturize it and warm it.

Normally, they change reactively depending on the humidity and temperature of the environment - due to the rush of blood, they swell, increasing in size, or, conversely, decrease in volume. Also, the submucosal layer and mucosa act as a protective barrier and prevent viruses and bacteria from entering the lungs (cellular and humoral defense). Another important function is the creation of inspiratory resistance for negative intrathoracic pressure, which regulates ventilation, blood supply to the lungs and heart.

However, with pathology of neurohumoral regulation of tone in the blood vessels located in the nasal turbinates, the submucosa and mucous membrane do not perform their functions. Vasodilation leads to tissue hypertrophy, causing

  • difficulty in nasal breathing;
  • nasal congestion;
  • sneezing;
  • stagnation of mucous discharge;
  • chronic rhinitis.

One of the most common problems today is rhinitis, in particular vasomotor and drug-induced (a special case of vasomotor). The symptoms of the pathologies are largely similar to the symptoms of allergic rhinitis, but the diseases have nothing to do with the body’s allergic reaction. Drug-induced rhinitis, as its name implies, appears due to the uncontrolled use of vasoconstrictor drugs with aggressive chemical effects on the mucous membrane and blood vessels. Vasomotor rhinitis can occur against the background of hormonal imbalance, endocrine pathologies, due to severe nervous tension and stress. Vasomotor rhinitis can provoke otitis media, sinusitis, and the appearance of polyps.

Conchotomy can improve the quality of life of a patient suffering from hypertrophy of the nasal passages, while maintaining the basic functions of the nasal turbinates.

Comparison of conchotomy with other methods and the advisability of its use

When choosing a treatment method for turbinates, it is important to eliminate the pathology while preserving physiological functions as much as possible. There is a lot of controversy surrounding conchotomy. Some rhinologists consider the method the least traumatic, safe and most acceptable; they recommend using it to treat hypertrophy of the nasal turbinate mucosa. Their opponents, on the contrary, speak out against the technology, calling it irreversibly destructive and aggressive. Equally controversial is laser destruction - a relatively new method of reducing the volume of pathologically hypertrophied shells. There are ardent supporters of laser destruction and equally staunch opponents. However, most rhinologists are inclined to believe that certain methods of treating turbinate hyperemia should not be unequivocally criticized. It’s good that there are quite a few methods and technologies, as this makes it possible to choose the method of treatment in each specific case.

At the moment, too destructive methods, such as cryosurgery, injections of sclerosing agents and corticosteroids, are practically not used. The authors of some scientific works also suggest, if possible, to abandon or minimize the use of chemical and electrical caustics, and subtotal turbinectomy.

Methods for performing conchotomy

Conchotomy began to be performed using a wire loop at the end of the 19th century. There is a description of total conchotomy, proposed a little later. However, this method of treating turbinate hypertrophy was found to be aggressively destructive, leading to dysfunction and secondary ozena - mucosal atrophy with symptoms of bleeding, crust formation, a feeling of dryness in the nose, pain, including headaches. However, the method of total conchotomy is still supported by some rhinologists, citing the lack of evidence of its harmful consequences.

Basically, partial conchotomy is performed - resection or surgical reduction of hypertrophied nasal turbinates and, if necessary, bone growths. The operation can be performed manually with a conchotome or a cutting nasal loop, without the use of devices. Another method of conchotomy is shaver destruction. Surgical intervention is performed using a microdebrider - shaver. This is a device with a rotating blade at the end and an electric suction. Hypertrophied tissue is cut off with a blade and then immediately removed with suction.

Laser cauterization is also often called conchotomy. The method has several advantages:

  • the operation can be performed on an outpatient basis and under local anesthesia;
  • the risk of bleeding is practically eliminated;
  • There is no need to use nasal packs.

The method is criticized because with minimal gentle influence it is not possible to remove a sufficient volume of hypertrophied tissue, and when removing a sufficient volume, physiological functions are irreversibly disrupted.

Any part of the shell can be selected for cutting, depending on the degree and location of the pathological growth. Most often in our time, rhinologists practice cutting off the hypertrophied posterior ends of the nasal concha.

Indications for conchotomy

Destructive operations are indicated for impaired nasal breathing and vasomotor rhinitis, chronic sinusitis, polypous and fibrous tumors in the nose and some other pathologies. If the disease cannot be treated with conservative methods, poses a threat to health, and worsens the quality of life, then a decision is made on surgical treatment - resection or surgical reduction.

In any case, the method of treatment and the need and method of surgical intervention are determined by the doctor after a thorough diagnosis and medical history. The success of treatment largely depends on the experience and qualifications of the ENT doctor.

Source: http://topdoctor.ru/articles/konhotomiya-nosovyh-rakovin

What is turbinate conchotomy?

Difficulty in nasal breathing often leads to the development of complications and significantly reduces the patient’s quality of life. Conchotomy is a surgical operation to completely remove the inferior and middle conchae of the nose or perform their resection. The purpose of the operation is to restore the patient's normal nasal breathing.

The need for surgical intervention is determined by the development of hypertrophic changes, as a result of which there is a pathological increase in the size of the nasal turbinates, which ultimately leads to impaired breathing through the nose. We are talking about deformation processes leading to hypertrophy of the nasal mucosa and proliferation of connective tissue. In some cases, bones and cartilage undergo changes.

The need for conchotomy

Conchotomy may be performed for a number of reasons. Most often, the need for surgery arises from hypertrophic changes in the nasal turbinates that have arisen against the background of rhinitis, when rapid growth of the epithelial tissue of the nasal mucosa is noted. The same can be said about deformation of the nasal septum, when the pathological process leads to blockage of the nasal passages and the development of active inflammation.

The absolute indications for conchotomy are:

  • long-term difficulty breathing through the nose;
  • sinusitis, characterized by a chronic process - as a result of enlargement of the shells, the outflow of secretory secretions from the nasal sinuses is disrupted, which leads to the closure of the anastomosis;
  • otitis, sinusitis, which has become chronic;
  • hypertrophy due to rhinitis;
  • nasal atresia;
  • congenital disorders of the anatomical structure of the nose;
  • narrowed nasal passages.

Pathological growth of the nasal mucosa, in addition to chronic diseases, can be facilitated by long-term use of drugs that have a vasoconstrictor effect.

If conservative therapy turns out to be powerless, then it is possible to normalize nasal breathing only through radical measures - resection of the nasal walls. In some cases, there is a need for rhinoplasty performed to correct the shape of the nose.

Sometimes hypertrophic processes affect not only the nasal mucosa, but also part of the periosteum, as well as bone tissue.

Hyperplasia can grow in all areas of the nasal concha and manifest itself in the form of foci. In this case, either the posterior or anterior terminal parts of the nasal conchae undergo hypertrophic processes. Often, chronic rhinitis entails the proliferation of the mucous membrane of the posterior ends of the inferior conchae; accordingly, patients are prescribed a posterior inferior conchotomy.

It is worth noting that at the onset of the disease, rhinitis can be cured with drug therapy. If the disease is mild, procedures such as cauterization, cryosurgery, and ultrasound therapy can help.

In cases where severe advanced hypertrophy is detected, in which there is an increase in the mucous membrane and bone tissue, it will be impossible to do without surgery.

Both the lower and middle shells can undergo hypertrophic processes. Most often, patients are prescribed a bilateral conchotomy of the inferior turbinates.

Contraindications for surgery

Conchotomy is far from a simple manipulation, but is a surgical intervention, and quite serious, which in some cases can be fraught with the development of consequences and complications. In addition, there are a number of contraindications when this kind of intervention is prohibited.

These include the following:

  • infectious diseases characterized by an acute course;
  • development of inflammation in the nasal cavity;
  • blood diseases;
  • endocrine disorders;
  • functional disorders of cardiac activity;
  • liver pathologies;
  • epileptic seizures.

Resection of the nasal sinuses, as well as their complete removal, should not be performed on pregnant women.

Conchotomy methods

Surgical operation of the nose to eliminate an area with hypertrophied mucosa can be performed through resection - excision of modified epithelial tissue. For this, a special surgical instrument called a conchotome is used.

In addition to this, there are other methods of conchotomy:

  • laser correction;
  • cryodestruction - the use of liquid nitrogen at low temperatures;
  • electrocoagulation conchotomy - cauterization of the epithelium with current, advisable at the initial stage of hypertrophy;
  • use of cutting nose loop;
  • surgery using ultrasound;
  • radiosurgical method;
  • Shaver conchotomy.

Surgery using a wire loop is extremely rare. This is due to the fact that the operation is quite complex and in almost every case leads to increased trauma. The intervention is carried out under general anesthesia, and the rehabilitation period takes several months. In addition, there is a high probability of complications and the formation of residual scar formations.

In most cases, the prognosis after surgery to remove hypertrophied mucosa is favorable.

Laser conchotomy of the nasal turbinates

The most popular method is nasal conchotomy performed with a laser. At the present stage, contact and superficial turbinectomy are distinguished. As a rule, local anesthesia is sufficient for this intervention. The operation is performed on an outpatient basis.

Cauterization of the epithelium with a laser is carried out with the aim of subsequent destruction of excess tissue formed in the nasal turbinates. The laser technique does not lead to bleeding, is famous for its lack of trauma and does not cause inflammation. In addition, the recovery period after surgery is quick and painless.

Ultrasound method

Surgical treatment with ultrasound is carried out using a special device called a disintegrator. The device is inserted into the nasal cavity to affect the epithelium.

Before the intervention, the nasal mucosa is treated with lidocaine solution. The procedure is painless, has a low degree of trauma and is well tolerated by patients.

Shaver conchotomy

One of the most modern techniques that are successfully used in the treatment of hypertrophic rhinitis is shaver conchotomy. In this case, endoscopic equipment is used.

The operation is performed using a shaver - a special medical instrument equipped with a blade and suction. During the operation, endovisor control is carried out: the image is displayed on the screen in an enlarged size.

Using this method, it is possible to perform both gentle anterior or posterior conchotomy and submucosal resection.

How is conchotomy performed?

The operation is performed either sitting in a surgical chair or in a supine position, in which the head should be slightly elevated.

The essence of the intervention is excision of areas with hypertrophied tissue. Conchotomy provides enlargement of the nasal passages and significant relief of breathing through the nose.

The duration of surgical procedures depends on the method of treatment and the degree of neglect of the disease. In a normal scenario, the operation takes about two hours.

In many cases, the proliferation of fibrous tissue provokes the development of deformation processes in the nasal septum.

Due to these circumstances, conchotomy can be performed in parallel with resection of the osteochondral nasal septum.

Only in this way can complete restoration of nasal breathing be achieved.

Immediately after the operation, nasal packing is mandatory. For this, gauze turundas soaked in a hemostatic solution are used. Tampons are removed from the sinuses 24 hours after surgical procedures.

Period after surgery

Immediately after conchotomy, you should avoid eating too hot and cold foods and drinks. It is recommended to drink as much as possible. In addition, you should minimize physical activity, do not overexert yourself and do not lift heavy objects.

During the rehabilitation period after surgery, you should strictly follow medical recommendations and strictly adhere to them.

Rehabilitation techniques involve the use of medications by applying them to the excision areas, as well as rinsing the nose with emollient solutions.

If the operation is successfully performed, nasal breathing is quickly restored, swelling is relieved, and nasal congestion disappears. In a normal situation, the duration of this period can vary from 7 to 21 days.

Conclusion

It is worth considering that conchotomy of the turbinates is a serious surgical operation; this measure is due to the need to restore impaired breathing through the nose and remove excessively overgrown fibrous tissue from the turbinates. In some cases, correction of the nasal septum is also expected.

You should only contact qualified rhinosurgeons in trusted clinics with a good reputation.

Directory of main ENT diseases and their treatment

All information on the site is for informational purposes only and does not claim to be absolutely accurate from a medical point of view. Treatment must be carried out by a qualified doctor. By self-medicating you can harm yourself!

Source: http://gorlonos.com/xirurgiya/chto-takoe-konhotomiya-nosovyh-rakovin.html

What is conchotomy (resection) of the nasal turbinates?

Almost every person experiences nasal breathing problems. This condition is determined by the intensive growth of the mucous membrane in the nasal cavity, which occurs as a result of some disease, such as a cold or due to the activity of pathogenic flora, the formation of polyps and other benign tumors.

Definition of turbinate conchotomy and the main difference from vasotomy

Conchotomy of the inferior turbinates is a common surgical procedure that involves complete or partial removal of the overgrown nasal mucosa using special scissors or a cutting loop.

This procedure can be used at any age and is prescribed even in childhood. The main indications for its implementation are infectious diseases, microbial carriage, frequent hypothermia, decreased immunity and chronic vasomotor or allergic rhinitis.

The main distinguishing feature of conchotomy from vasotomy is that the first procedure is characterized by resection of the inferior turbinate, partially or entirely, and in the process of vasotomy the volume of the turbinate is reduced.

Purpose of the submucosal conchotomy operation

Conchotomy of the inferior turbinates is prescribed in the following cases:

  1. The presence of previous infectious pathologies - sinusitis, sinusitis, frontal sinusitis, rhinitis.
  2. Long-term nasal congestion.
  3. Development of polyps.
  4. Congenital anomalies in the development of the nasal septum.
  5. Nose injuries.
  6. Violation of trophism of the mucous membrane.

If there is extensive growth of the nasal mucosa, the patient is prescribed a bilateral conchotomy of the inferior turbinates.

Preparing for surgery

Before prescribing a conchotomy to a patient, the doctor sends him for a full medical examination, which includes:

  1. General blood and urine analysis.
  2. Biochemical analysis of blood and its coagulability.
  3. ECG.
  4. Endoscopic examination of the nasal cavity - allows you to assess the condition of the mucous membrane and determine the actions during the operation.
  5. X-ray examination.
  6. CT scan.

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Progress of the conchotomy operation

Resection of the inferior turbinates is performed under local or general anesthesia in a hospital setting. The progress of the procedure is determined by the following actions:

  1. The mucous surface of the nose is lubricated with an anesthetic solution and then an anesthetic drug is injected.
  2. During the operation, the doctor uses special scissors and a cutting loop.
  3. Clothes pins are applied to the resection area on both sides to reduce bleeding, and the mucous membrane is removed using surgical instruments.

The final stage will be the application of a bandage and instructions on proper care of the operated area.

Types of conchotomy

  • Laser conchotomy

The laser method of conchotomy of the inferior turbinates is the most common surgical intervention. This operation is considered modern and involves the impact of a laser beam on the surface of the mucosa.

It involves the use of a special device that emits ultrasonic waves. Before the procedure, the nasal surface is treated with an anesthetic to reduce sensitivity.

  • Endoscopic conchotomy

This is a modern method of treating people with upper respiratory tract diseases. This procedure is especially often prescribed for complications of rhinitis due to prolonged nasal congestion.

  • Shaver conchotomy

It is the most modern surgical intervention. Shaver conchotomy is determined by the use of special endoscopic equipment. During the operation, the doctor uses a shaver, which is equipped with additional devices, and thanks to it, resection of the mucous membrane is carried out.

Consequences and recovery after conchotomy

Proper care minimizes the consequences of surgery

If unforeseen situations occurred during the operation or it was performed incorrectly, the consequences of conchotomy may occur.

Their occurrence is also greatly influenced by proper care and treatment of the nose.

Respiratory failure as a result of conchotomy is a common phenomenon that develops as a result of damage to the mucous membrane. If the operation is performed correctly, then after a few days the congestion goes away and breathing is restored.

As a rule, after conchotomy, crusts form at the site of resection of the mucous surface, which are subsequently replaced by new tissue. They go away differently for each patient, which depends on the regenerative abilities of the body. But more often, by the end of the week after the procedure, they should leave.

To prevent blood clots in the operated area of ​​the nose, the patient is prescribed the drug Fibrin. In this case, it is applied topically in the form of a gel. When taking, you should carefully observe the dosage so as not to provoke complications. The frequency and duration of administration, as well as the dose of the drug, are determined by the doctor.

Vasoconstrictor drops after conchotomy

To facilitate nasal breathing and reduce swelling of the mucous membrane, vasoconstrictor drops may be prescribed after surgery. But they should only be used as directed by a doctor. Popular drugs that have such pharmacological properties are:

To stop bleeding after removing the mucous membrane, the doctor inserts a tampon into each nasal passage, which must be periodically changed and lubricated with a medicine for rapid tissue healing.

Photo gallery after conchotomy

Cost of conchotomy surgery

Photo of conchotomy

Video of conchotomy

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For 10 years I have been using nasal drops regularly, they are always with me in any situation, because without them I cannot breathe. I became so addicted that I got up several times at night and used 2-3 bottles a day. One day I got tired of it and all my relatives referred me to an ENT specialist, who after an examination recommended surgery. The conchotomy was performed successfully, 6 months have now passed, there are no complications and the nose can breathe freely.

Due to a complicated form of rhinitis, I began to often buy vasoconstrictor drops, and I started having problems breathing and sleeping. After one sleepless night, I shared this with my friend, she recommended a conchotomy, which was done by her sister. Without hesitation, I made an appointment with a doctor, then underwent tests and was sent for surgery. A year has passed since it took place, I am very grateful to my friend and doctor. From that moment on, I began to breathe well and no longer use drops.

2 weeks ago I had a bilateral chonchotomy, because for a long time I suffered from severe nasal congestion, my nose was not breathing at all, and it was unbearable to sleep in recent months. The operation was performed under general anesthesia; no unpleasant sensations arose during it. Now the rehabilitation period is almost over, the bandages were removed, the doctor prescribed the use of special drops, the improvements are noticeable.

Hello, I had a conchotomy. Half a year has passed and it’s terrible, the air is bad, my throat is constantly dry, I’ve become so nervous that I can’t describe it, I don’t get enough sleep at night. Conclusion !!wait with the operation... try other options!.

I have the same. I had surgery almost three years ago, bilateral conochromia. All three years I had breathing problems when walking. Now the situation has worsened.. I wake up at night with a burning sensation in my nose. Rinsing and sprays do not help. Horror. If I had the opportunity, I would never repeat this mistake. It was just a severe cold and a deviated septum, but the doctor persuaded me to have an operation. Refrain if possible.

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Source: http://nos-zdorov.com/operacii/konxotomiya-nosovyx-rakovin

Conchotomy - what is it and what is it used for?

The structure of the nose is such that any deviation in the location of its septum or cartilaginous growths can cause difficulty breathing. The nasal turbinates are covered with mucous membrane and separated by passages; they provide warming and humidification of the inhaled air.

In their membrane there are cavities filled with blood; if it is retained, the lower nasal turbinates swell, which makes it difficult to inhale air. This problem is solved by a special method - conchotomy. The technique is aimed at removing the inferior turbinates together with the mucous membrane.

What is conchotomy

This is an operation to remove blood-filled nasal turbinates. It has other alternative names: osteoconchotomy, turbinectomy, cryoconchotomy and endoscopic osteoconchotomy.

During conchotomy, complete or partial removal of the nasal turbinates is performed, the mucous membrane of which begins to grow due to certain diseases, the treatment of which with medications is ineffective. After such an operation, the lumen of the nasal passage is cleared and the person begins to breathe normally.

Surgical intervention for the main conchotomy involves excision of the altered epithelial tissue with a special instrument - a conchotomy. The operation with it is quite complicated and borders on increased trauma. Anesthesia is used to carry it out, and the rehabilitation period lasts several months. After the incisions heal, adhesions may appear.

Rhinoplasty, septoplasty and conchotomy are compared in this video:

Due to a number of its shortcomings, such a conchotomy is now carried out less frequently than its more modern types, which include:

  • Laser conchotomy. This is the most popular technique, which is carried out using a laser. It is performed under local anesthesia on an outpatient basis. The laser cauterizes the epithelium, this effect leads to the destruction of unnecessary tissue, which, due to unfavorable factors, grows in the nasal turbinates. Due to the precision laser, which has anti-inflammatory, coagulation and antiseptic properties, the operation takes place without unnecessary blood loss and inflammation, and also does not cause injuries. After laser treatment, the rehabilitation period is only a few days. This technique is widely used for bilateral conchotomy.
  • Cryodestruction involves the use of low-temperature liquid nitrogen, which guarantees painless surgery.
  • Radio wave surgery. It uses the Surgitron device, from which a current is supplied to the surgical loop, which is directed to remove excess tissue. The operation with it takes place without pain and blood on an outpatient basis. The recovery period lasts only 3 days.
  • Shaver conchotomy. The technique involves the use of endoscopic equipment; it has a special tool - a shaver, on which a suction and blade are located. The doctor monitors the progress of the operation and its nuances using a monitor in an enlarged size, this is called endovisor control. Using the seamstress's blade, the excess tissue is “shaved off”, he immediately crushes it and these pieces are removed from the nasal passages using suction. This method makes it possible to perform posterior and anterior conchotomy, as well as submucosal resection.
  • Ultrasound technique. It uses a special device – a “disintegrator”. Its tip is inserted into the nasal cavity in order to influence the overgrown epithelium of the mucous membranes. Before the operation, anesthesia with lidocaine is carried out, so the operation is easily tolerated and there are no injuries after it.

Bilateral conchotomy of the inferior turbinates

Combination with other procedures

Conchotomy can be used along with techniques such as vasotomy or septoplasty. The action of vasotomy is aimed at eliminating the vessels hidden behind the mucous membrane of the nasal turbinates, and septoplasty corrects the deviated nasal septum, no matter for what reason it has changed its position.

Indications

Conchotomy is performed in the following cases and in the presence of the following diseases:

  • choanal atresia;
  • too narrowed nasal passages;
  • fusion of the mucous membrane;
  • hypertrophy of the nasal mucosa;
  • chronic rhinitis, sinusitis, otitis and sinusitis;
  • congenital anomalies of the structure of the nose.

If conchotomy fails, the patient can resort to rhinoplasty, which changes the shape of the nose.

Contraindications

Conchotomy is a simple, but at the same time traumatic operation; complications may occur after it, which is why there are a number of factors in which its implementation is unacceptable:

  • deviations in the functioning of the endocrine system;
  • the presence of inflammatory processes in the nose;
  • various blood diseases;
  • disruptions in the functioning of the heart muscle;
  • acute manifestation of infectious diseases;
  • epileptic seizures;
  • liver pathologies;
  • purulent otitis media or sinusitis;
  • somatic pathologies.

Shaver conchotomy under endovideo control is shown in the video below:

Carrying out

Before the operation, it is necessary to prepare and undergo special studies.

Preparation period

In addition to routine urine and blood tests, you will need to undergo the following examinations:

You should definitely consult with an ENT doctor and, if necessary, undergo a brain tomography. If necessary, if you have related diseases, consult a therapist and cardiologist.

The operation is performed in a chair or on a table; the choice of location depends on the skill of the doctor and the equipment used.

Posterior inferior conchotomy

Progress of conchotomy

  • With any method of conchotomy, excess mucous tissue is removed from the nasal turbinates. After such an operation, a person’s breathing becomes significantly easier.
  • Since the proliferation of fibrous tissue in most cases leads to deformation of the nasal septum, septoplasty is performed together with conchotomy to straighten it.
  • As soon as the mucous membrane is excised and its remains are eliminated, tampons are inserted into the nasal passages. They are prepared from gauze turundas soaked in a hemostatic solution. They will need to be removed one day after surgery.

Rehabilitation

After conchotomy, you should not eat hot or cold foods, and the volume of liquid you drink must be increased. During this period, you should avoid physical activity and try to bend over less. It is necessary to strictly follow the doctor’s recommendations to avoid complications.

During the rehabilitation period, the nose is washed with a solution, and special medications are rubbed onto the excision areas. The bandage from the nose can only be removed by a doctor who knows when it is best to do this. To reduce swelling and speed up the healing of incisions, the doctor may prescribe the following types of drops: Rinazolin, Naphthyzin, Imidine.

The duration of the healing process of the nasal passages ranges from 7 to 21 days. After this, you will need to regularly carry out special exercises for the nose, which will allow you to breathe normally.

Possible complications

Even modern methods cannot guarantee a 100% result without certain risks; possible complications include:

  • nasal deformity;
  • purulent inflammatory processes;
  • formation of adhesions;
  • dry nose syndrome;

Price and clinics

Conchotomy is a serious operation that can only be performed within the walls of specialized clinics. When choosing which, you need to check their reputation based on reviews, and also make sure that the appointed rhinosurgeon is sufficient and competent to perform such operations.

The cost of the operation will depend not only on the equipment used, but also on the reputation of the clinic and its location; in large cities it will cost more. Basically, the issue price ranges from 2.5 thousand rubles to 8 thousand.

Reviews

Judging by the responses of people, those who are most often dissuaded from carrying out such an operation are those who are afraid to do it themselves. If you take a comprehensive approach to the issue and study all the nuances of the procedure, then within a month you can breathe through your nose and forget about the difficulties with this. After laser conchotomy, most often you don’t even need to walk with tampons, and breathing will be completely restored on the third day.

The combination of the operation with septoplasty is shown in the video below:

Source: http://gidmed.com/plasticheskaya-hirurgiya/vidy/esteticheskaya/nos/konhotomiya.html

Conchotomy is my second nose surgery

Conchotomy

Conchotomy is the name of the operation to remove the nasal turbinates; I have even heard something similar from doctors many times.

Set of instruments for nasal conchotomy

  • 1 - injection needles;
  • 2 — beakers for anesthetic substances;
  • 3 — “Record” syringe with a volume of 10 ml;
  • 4 — nasal probe with thread;
  • 5 - hammer;
  • 6 - Strucken's conchotome;
  • 7 - scissors at an angle;
  • 8, 9 — different conchotomes;
  • 10 — Hartmann forceps;
  • 11 — bayonet tweezers;
  • 12 - spatula;
  • 13, 14 — Killian’s nasal dilators (mirrors);
  • 15 - Kocher clamp.

Of course, some of the tools described above were not there, but in general the picture was something like this, except that the syringes were much more modern. Okay, let's get back to the operation itself.

By the way, the operation has long been prohibited all over the world; it causes a crooked nose, in which there is little cartilage left, and constant illnesses, because the air does not heat up and is not moistened in the nose, and there are a lot of accompanying side effects. If possible, treat without surgery, and surgery only with laser, electricity or freezing.

Operation with scissors is nonsense, forget it, never do it - it’s a thing of the past.

But I’ll say right away that it clearly depends on the body. Some patients I have personally seen tolerate it well. but many, like me, “died” from pain)))

I’m probably responsible for the sins of my parents...since I had to go under the knife for conchotomy three times ((((

Now I’m 34. I’m 10 years old and I seem to be breathing... but the consequences are not the best. As a result, there are constant crusts in the nose, as if with pus sometimes. For prevention, you have to wash it with baking soda and water.. The scary thing is that it lasts for life. ((((

I had to go for surgery for the first time - because already in the 9th grade - I had to take at least 1 bottle of naphthyzine with me to school... I stupidly took it and poured it into my nose in half a day. it was a terrible dream. no studies, only thoughts in my head about how to “dig in.”

It's just HELL. the first two times, women did it. All the freezing didn’t help me. I felt all this crunching and pain... the result was zero. As a result, after 5 years, the third operation was the 4th hospital on Rozochka. God bless this doctor - Alexey Ivanovich Bazan!!

This is a strong man who performed operations like an assembly line!! This is tough, I often watched in the corridor as he came out with a wet back through his operating room robe. The job is not for the faint of heart.

During the third operation, as Nikita wrote above, he almost lost consciousness. I still lost him. it was very bad, as I remember now. there was a clock hanging - when I woke up in the operating chair, the time was 20 minutes ahead and there were a bunch of legs standing, I just remember, next to me.

After the operation, my head hurt for 24 hours so much that I wanted to tear it off and throw it to the dogs. )))

The Ibuklina tablets saved us, our whole ward prayed for them))) but that’s if they are not contraindicated!!

As a result, all sorts of hormonal drops in the nose. something like Flixonase or Avamis will be prescribed and recommended to you constantly.

I am very afraid that my youngest daughter, at 5 years old, is now also starting to snore and cannot breathe through her nose; an ENT operation has already been recommended by the doctor ((((..

Ps. The main thing I wanted to say and convey to future patients.

If possible, perform surgery using a laser method. I don’t recommend going under the knife. firstly, tamponing - blood pressure is still the same.

Secondly, I think the consequences with crusts, as I have, will be less.

Thank you everyone and don't get sick.

I love this business (easy, useful operations). But I was never given an IV. I'm very afraid.

By the way, you know how to describe the situation in words - “the heartbeat slowly began to recover to a normal rhythm, the excitement faded away” or “a syringe with a regular needle, and two more using some kind of long, thick needle that resembles a knitting needle. With the help of this needle they pierced something in my nose with a crunch. It didn’t hurt anymore, but I heard that crunch quite clearly.” wow)

Source: http://10kilogramm.ru/konhotomiya-moya-vtoraya-operaciya-na-nosu.php