Laser Nasal Surgery to Correct Nasal Blockage

The Dynamics of Nasal Breathing

We'll begin by explaining how your own particular nasal anatomy affects your ability to breathe through your nose.  The ability to breathe well through your nose depends on two critically important structures inside your nose: the nasal septum and the nasal turbinates.  If you also have scar bands from nasal injuries or prior surgeries, polyps or cysts inside your nose that block your breathing, Dr. Feinberg will eliminate these problems as well -- with the help of his elegant laser techniques. 

The Nasal Septum

The nasal septum is like a wall composed of  both cartilage and bone,  dividing the inside of your nose into the right and left breathing passages.  In order to permit free air flow through your nasal passages, your septum needs to be straight.  If your septum is crooked ("deviated" in medical terminology), your nasal airway will be blocked, often very significantly.

Deviated areas of your septum can take an amazing variety of forms: angling to one side in the front of your nose then to another side in the back, deviated at the very bottom of your septum and way up high.  Dr. Feinberg has even corrected septums that were so crooked they headed directly across the patients' nasal passages, totally obstructing their breathing.  Only surgery can correct a deviated septum  -- medicines have no effect on a deviated septum.

Your deviated septum can be an anatomic feature you inherited or your deviated septum can be caused by trauma to your nose -- falling off your bicycle, an accidental blow from an elbow, a basketball or football injury, falling against a table, walking into a door.

The Nasal Turbinates

The turbinates are large scrolls of bone on the side walls of your nose.  The turbinate bone is covered with thick, pink nasal lining containing many large blood vessels.  When you look inside the nose, the turbinates look like plump, pink cylinders with bony attachments to the side wall of the nose.  Their function is to warm and humidify the air that passes through your nose into the back of your throat and then through your voice box and windpipe into your lungs.

On each side wall of your nose (right side and left side) there are actually three turbinates: the inferior (lowest) turbinate, the middle turbinate, and the superior (highest) turbinate.  The inferior turbinate is by far the most important turbinate affecting your ability to breathe through your nose.  Consequently, when Dr. Feinberg describes turbinate surgery later in this talk, he is really referring to surgery he performs on the inferior turbinates.  Only occasionally, surgical reduction of the middle turbinate might also be needed, usually involving a trim of the front or lower edge where polyps arise.  The superior turbinate is quite small and is not involved in turbinate surgery.

Because your nasal septum is covered with a very thin lining, the septum changes its size very little.  But because your inferior turbinates are covered with a very thick lining filled with many large, reactive blood vessels, your turbinates can enlarge very dramatically -- you'd be amazed at how massive and obstructive they can be.  Your turbinates are extremely sensitive to a wide variety of factors.

The most common cause of massive swelling of the turbinates, the cause that creates billions of dollars in sales for pharmaceutical companies ( using the money that comes out of your pocket) is: Allergies!  Your turbinates are Prime Target Organs for your allergies -- whatever you're allergic to selectively targets your turbinates and hits them hard!  Then your turbinates swell up massively, causing severe nasal blockage, sneezing, watering, itching, and facial pressure.  (See the extensive conversation with Dr. Feinberg about your nasal breathing and allergies under Nasal Allergy Problems.)

Other causes of massive swelling of your turbinates are:  air temperature changes, humidity changes, pollutants in the air, cigarette smoke, chemical irritants, water absorption when swimming, and infection when you get a cold or sinus problems.

When your turbinates swell, they block your nasal breathing very severely.  At night, when you're lying in bed trying to sleep and struggling to breathe through your nose, your turbinates get even bigger -- because the blood pools in your turbinates by gravity and enlarges them when you're lying flat.  If you lie on your left side, the turbinates on the left side wall of your nose enlarge; same on your right side.  When your patience runs out and you get out of bed and stand upright, gravity helps to drain a little of the pooled blood out of your turbinates and you may be able to breathe a little better through your nose. 

 Your Options For Treatment

Isn't it time to end all your years of suffering with nasal blockage and allow Dr. Feinberg to recommend a definitive, permanent cure?

For the overwhelming majority of patients, there are two major causes for your severe nasal blockage:

             1) your septum is deviated

             2) your inferior turbinates are excessively large.

What are your treatment options?

For your deviated nasal septum there is only one option: septal surgery. Medicines are of no value in the treatment of a deviated septum.  In addition, your deviated septum can not be corrected by more limited surgical techniques with you awake, such as merely cooking the soft tissues of your turbinates with the laser or sticking heated needles into your turbinates.

For your excessively large inferior turbinates there are two options: medications for temporary shrinkage of nasal turbinates (when you stop your medicines, the shrinkage stops) or turbinate surgery offered by Dr. Feinberg for a definitive, permanent cure.

IMPORTANT ADVISORY:  If Dr. Feinberg determines during your initial consultation that you require surgery to correct a deviated septum as well as surgery to reduce your excessively large inferior turbinates, Dr. Feinberg routinely performs both your required septal surgery and your turbinate surgery at the same time under the same anesthesia.

Let's review each of your treatment options in more detail.

Dr. Feinberg's Outstanding  Approach to Septal Surgery

After 30 years of  performing nasal surgery to correct nasal  blockage, Dr. Feinberg's technique has evolved to a state-of-the-art level incorporating the cutting edge carbon dioxide laser to achieve truly outstanding results.

How does Dr. Feinberg achieve these exciting results?  As in many other fields of endeavor, Dr. Feinberg combines multiple skills, hard work and dedication to provide only the best results for each of his patients, including you.  All of the following elements are important in Dr. Feinberg's surgical results:

  • Thorough, time-consuming evaluation of each patient before surgery even begins:

    Dr. Feinberg will take a detailed history of all symptoms regarding your nasal blockage and perform a very complete painless examination of the inside of your nose, including the use of his modern ultrathin fiberoptic scope.

  • Pioneering use of the carbon dioxide laser:

    Dr. Feinberg has developed exciting new uses for the laser when performing extensive septal and turbinate surgery, in combination with other surgical instruments.  Early on, Dr. Feinberg recognized the benefits to his patients of using the laser: the laser cuts in a very precise, elegant manner while sealing small blood vessels at the same time.  Because Dr. Feinberg's laser limits the spread of laser energy to only the precise area he cuts, the adjacent tissue is spared and healing after surgery is much faster; in fact, healing time in his patients has been cut in half with his laser techniques! And Dr. Feinberg has discovered that the laser is spectacular at precise, gentle cutting through scar tissue binding the pink nasal lining to each side of the septal bone and cartilage -- scar tissue due to prior nasal injuries or previous nasal surgery by other doctors.

  • Complete correction of ALL, not just some, of the septal deviations that block your nasal breathing: 

    Correcting the septal deviations (the crooked parts) in the central portion of your septum is relatively easy.   But in order to achieve truly outstanding nasal breathing, all septal deviations --from the very front edge of your septum (where twisting can block one nostril) to the very back edge of your septum must be expertly corrected -- as Dr. Feinberg does for each of his patients.  As part of the same thorough approach to septal surgery, Dr. Feinberg will correct all septal deviations from the crooked, obstructive bone at the bottom of your septum to the crooked septal cartilage and bone at the top part of your septum.

Correcting the crooked parts of your septum at the front, back, top, and bottom of your septum requires not only  considerable extra time but also the highest degree of skill in septal surgery.  So why does Dr. Feinberg do it?  The answer is simple:  in order to be able to breathe really well through your nose, you must have an open nasal passage from the front all the way through to the back of your nose -- merely opening the front or middle of your nasal passage and leaving the back of your nasal passage still blocked will NOT help you to achieve clear nasal breathing!  This is just plain common sense, isn't it?



Any information provided on this Web site should not be considered medical advice or a substitute for a consultation with a physician. If you have a medical problem, contact your local physician for diagnosis and treatment.
© 2012 Barry J. Feinberg, M.D.