Histopathological Study of Hypertrophied Inferior Turbinate

Background: Prolonged perceived nasal obstruction resulting from inferior turbinate hypertrophy (ITH) is a common complaint encountered in Otorhinolaryngology practice. A wide variety of surgical procedures like partial resections, submucous resection, electrocautery, submucous diathermy, cryosurgery, laser ablation and endoscopic resection have been performed but results have been universally unsatisfactory. There is very less literature available regarding Histopathological aspects of hypertrophied inferior turbinate which can throw more light on appropriate management of hypertrophied inferior turbinate. Hence this study was undertaken to provide quantitative and qualitative information on various soft tissue and bony constituents of hypertrophic inferior turbinate. Objective: Comparison of Histopathological features between inferior turbinate hypertrophy in allergic rhinitis, non-allergic rhinitis and deviated nasal septum. Materials and methods: A total of 100 patients who presented with nasal obstruction due to hypertrophied inferior turbinate were chosen for study. All patients underwent partial turbinectomy of hypertrophied inferior turbinate under general anesthesia with or without septoplasty. Turbinectomy included anterior 2/3rd of turbinate and all the layers including the bone were excised during the procedure. The turbinate specimens were processed in standard manner in the department of pathology and slides were prepared from sectioning anterior 1/3rd of the specimen taking care to include all the three layers of the turbinate. Results: In our study mean total thickness of inferior turbinate in DNS with ITH group was 5.27±0.98 mm and in allergic rhinitis group was 5.05±0.60 mm. Mean thickness of medial mucosal layer in DNS with ITH group was 1.58±0.33mm where as its thickness in allergic rhinitis group was 2.30±0.43mm. Thickness of bony layer was 2.54±0.53mm and 1.55±0.44mm in DNS with ITH group and allergic rhinitis group respectively. Mean thickness of lateral mucosal layer was 1.16±0.38mm in DNS with ITH group and 1.19±0.22mm in allergic rhinitis group. Conclusion: With these results we conclude that bone should be the target of surgery in treatment of hypertrophied inferior turbinate secondary to deviated nasal septum where submucous resection of bone or turbinoplasty is adequate to relieve the symptoms of nasal obstruction where as in cases of allergic rhinitis with hypertrophied inferior turbinate where only medial mucosal layer is hypertrophied, limited resection of the mucosa either by diathermy or by other conservative methods may suffice.