Each nasal cavity contains three turbinates (conchae): inferior, middle and superior. The inferior turbinate regulates nasal airflow, humidifies inspired air and contributes to filtration in the upper airway. Its rich vascular network contracts and expands in an alternating pattern known as the nasal cycle, lasting about 2–6 hours, so that total nasal airflow remains stable while the side of greater passage changes.
Enlargement of the inferior turbinate is an important cause of nasal obstruction. The anterior portion of the inferior turbinate is a component of the internal nasal valve, which accounts for approximately 50% of total airway resistance. The contribution of the inferior turbinate to obstruction is both structural and functional; turbulent flow may create a sensation of blockage. Airway resistance that is either too high or too low can produce that sensation.
Radiofrequency reduction of the turbinate is a widely used, incision-free method. The aim is to widen the airway while preserving mucosal function. Energy from radio waves produces ionic movement at cellular level; the resulting heat acts only 2–4 mm around the active electrode, in deep tissue. Surface lining is preserved while shrinkage in the treated area reduces turbinate volume.
The procedure can be performed under local anaesthesia in office or operating-theatre conditions. It does not typically require nasal packing. Bleeding afterwards is uncommon. Transient turbinate oedema may occur from the 24th hour and settle during the first week. Crusting that improves with saline irrigation may be seen. Surgical change in turbinate volume should be assessed from the third week onwards.
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