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What Causes Decreased Blood Flow Through The Nose While On A Turbinate?

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Posted on Wed, 18 May 2016
Question: Dear Doctor.
You may remember me from back in December when we communicated.
I was going to have radio frequency turbinate reduction on only my left turbinate.
I did have the procedure approximately 9 1/2 weeks ago. I had the bare minimum: 1/2 lesion reduction on just one turbinate.
Please bear in mind that another ENT actually thought he could do a partial resection on that turbinate -- so two doctors felt that the turbinate could be reduced.
But I chose this bare-minimum approach through radio frequency.
Two weeks after I had the procedure, I caught a significant cold virus -- which I didn't fully recover from until 2 weeks later.
My doctor feels that having that the cold probably delayed my recovery. While I'm breathing better much of the time from both nostrils, I have an issue, from time to time, that concerns me - hence my outreach to you.
At certain times, maybe 2-3 times a day for 30 minutes or so, usually after I have blown my nose, either hard or even gently, the nasal passage where I had the procedure feels unusually cold. A sensation which I've never felt before. I don't feel like there's too much air going through or anything like that. It just feels very cold for these brief periods.
It never lasts for more than 30 minutes or so, and is NOT constantly occurring -- but it does seem to happen about 2-3 times a day, again usually after I blow my nose, even gently.
My ENT has indicated on each follow up visit since the procedure that the turbinate definitely is not too small and that he did a very small amount.
So what do you think could be going on? Is this just an effect of the turbinate still healing, even though it's been nearly 10 weeks?
I did have that cold for 2 weeks, so maybe I'm really at just 8 weeks in effect. But I worry what's going on.
Thank you.
doctor
Answered by Dr. Sumit Bhatti (14 hours later)
Brief Answer:
This transient sensation will settle down in time.

Detailed Answer:
Hi,

Thank you for writing back.

1. The cold must have delayed your recovery.

2. This transient cold feeling is not very common but will be related to decreased blood flow through the nose as the nasal cycle resets.

3. In my opinion, it should fade away in time.

4. Start a steroid nasal spray, an anti-allergic, mucolytic medication and steam inhalation for a few weeks. Let me know the progress.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (49 minutes later)
Thank you.

You indicate it's not very common -- do you believe that it's NOT related
to any permanent damage to the turbinate?

It's my understanding that the turbinates are supposed to warm the nasal passages -- hence my concern.

Could you explain a bit more about this decreased blood flow?

And last, I did read somewhere that it could take 12 weeks in some people for full healing from the radio frequency turbinate -- I know they normally say 6-8 weeks, but I did read the 12 weeks in a few places.

What is your experience in this regard?

Thank you.
doctor
Answered by Dr. Sumit Bhatti (1 hour later)
Brief Answer:
You will get further improvement.

Detailed Answer:
Hi,

Thank you for writing back.

1. Yes, each individual responds in a slight variation during the recovery period after any medication and surgical intervention. The same holds true for radiofrequency turbinate volume reduction (RaVoR).

2. A the internal blood vessels in the nasal turbinate is ablated, changes in blood flow are bound to occur as planned. The volumetric variation of turbinate size is due to blood flow variation.

3. Many patients are counselled to wait for 8 to 12 weeks. Almost all patients feel better after this time. For example, after Endoscopic Sinus Surgery, internal healing may take 4 to 6 months.

4. Hence patience is advised. You will get further improvement.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (51 minutes later)
Thank you. Last question: just to be clear that I understand fully, you indicate
that you think the radio frequency procedure, and my healing from it, is effecting a transient decreased blood flow
in the turbinate, which is causing the cold sensation, which should fade over time as I heal -- correct?

Thank you again
doctor
Answered by Dr. Sumit Bhatti (7 hours later)
Brief Answer:
Yes. That is correct.

Detailed Answer:
Hi,

Thank you for writing back.

1. Yes, that is correct.

2. There is always some degree of mucosal injury after the procedure which heals. This may also be the cause of the sensation.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (42 hours later)
Thank you.
doctor
Answered by Dr. Sumit Bhatti (10 hours later)
Brief Answer:
Wish you a speedy recovery.

Detailed Answer:
Hi,

Thank you for writing back.

Wish you a speedy recovery,

Regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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What Causes Decreased Blood Flow Through The Nose While On A Turbinate?

Brief Answer: This transient sensation will settle down in time. Detailed Answer: Hi, Thank you for writing back. 1. The cold must have delayed your recovery. 2. This transient cold feeling is not very common but will be related to decreased blood flow through the nose as the nasal cycle resets. 3. In my opinion, it should fade away in time. 4. Start a steroid nasal spray, an anti-allergic, mucolytic medication and steam inhalation for a few weeks. Let me know the progress. I hope that I have answered your query. If you have any more questions I will be available to answer them. Regards.