Conchotomy
A conchotomy is an operation that aims to reduce the size of the turbinates ( conchae nasales ) to facilitate nasal breathing.
Methods
Stripe Conchotomy
It is also called clam capping. In the original conchotomy, also known today as a strip conchotomy, a strip of mucous membrane a few millimeters wide is cut off with long scissors from the lowermost turbinates on each side at their lower end. Usually the nasal passages have to be tamponized for a few days.
Laser conchotomy
Since the strip conchotomy is comparatively bloody and can generally only be performed under anesthesia , alternatives have been developed. Burning a strip a few millimeters wide on the underside of the lowest mussel with a diode laser is widespread. This method can be performed well on the awake patient.
Shell caustic
Other methods rely on inserting electrodes into the lining of the turbinates through which a high-frequency current is passed ( high-frequency or radio-frequency surgery), which leads to burns in the deep layers of the mucous membrane. In the following days and weeks there will be scarring. As the scars contract, the turbinates get smaller too.
Risks and possible complications
Overall, it is a very low-risk procedure. The turbinates are used to moisten the nose . If too much is removed from the mussels, they can no longer do their job and the nose can dry out (so-called rhinitis sicca) ( empty nose syndrome ). In extreme cases, it becomes clogged with dry crusts that are colonized by bacteria and a so-called stinky nose ( ozaena ) develops . However, the mucous membrane of the turbinates is very capable of regeneration. With modern, gentle surgical methods and the right approach, the ozaena is a very rare complication. Rather, there is the problem that the mussel mucosa often grows back and the effect of the operation is lost after just a few years. In principle, the operation can be repeated any number of times. Often the combination with straightening the nasal septum ( septum deviation ) makes sense and lasts longer.
For blood clotting disorders, e.g. B. when taking anticoagulant drugs such. B. Aspirin or Marcumar, it can lead to massive bleeding / secondary bleeding. In the case of an aggressive strip conchotomy, larger scabs can form, which require follow-up treatment. Occasionally adhesions or scars form between the operated turbinate and the nasal septum with hindrance to nasal breathing, which must be surgically resolved.
