nose1 wrote:

Mmpfus wrote:Does it in fact mean 0% of turbinate remaining? Or is it just that the doctor goes in without intent of leaving anything behind?  I think I have read about "total turbinectomy patients who have 10, 20, 30% of turbinates remaining (all estimates of course).


Do those patients literally never experience any nasal congestion at all, their experience of their nose is just a permanently wide open hole back through to their throat?  


If that is the case, I do have a very difficult time imagining anyone could be "fine" with that.  However, I am really just trying to understand what "total turbinectomy" means.


Really I am not certain how it can be guaranteed that the endgame of these various procedures is necessarily always different.  Whether you had a "total", "partial", or "submucosal mucosa-preserving" resection, if your tissue eventually drys out, atrophies, and dies I really don't see what difference it makes.


 

There is no magic number that determines what a "total" turbinectomy is. It is essentially that the surgeon removed the vast majority of the turbinate. I don't think someone that has 5% of a turbinate remaining would be in a significantly different spot than someone with 15%. They both would have very little turbinate remaining. 

The biggest issue with ENS is that it is not fully understood. All explanations lack a complete explanation for all scenarios. It is still unclear why some people with little remaining turbinate tissue seem OK and why some people with seemingly more conservative procedures suffer greatly.  Whether we fully understand the mechanism behind it, the reality is that there are people with basically total turbinectomies that seem fine. In some ways, it doesn't matter what surgical procedure was performed or the the amount of remaining tissue, because it is the symptoms that matter. Someone with a total turbinectomy that is fine, needs no intervention. Someone with a theoretically more conservative procedure that has severe symptoms does need intervention. Probably the main reason why the remaining percentage of tissue matters is when deciding the treatment. Someone with very little turbinate is much more likely to need an implant. Someone with a large amount of tissue is more likely to respond to regenerative medicine that can reduce the tissue damage. 

why are turbinectomys even performed in the first place? lucrative doctors? I thought surgery was meant as a last resort. maybe I'm just upset I signed up for surgery to fix an allergy issue. I'm complete idiot.