The histopathology of the hypertrophic inferior turbinate.
OBJECTIVE
To analyze the quantitative and qualitative characteristics of the hypertrophic inferior turbinate (IT).


METHODS
A prospective, nonrandomized, controlled, morphometric study.


METHODS
University-affiliated hospital. Subjects Seventeen patients with refractory IT hypertrophy and 12 with normal ITs.


METHODS
Twenty ITs were removed from patients with refractory IT hypertrophy and 14 from patients with normal ITs.


METHODS
The soft tissue and bony elements and the relative proportions of the soft tissue constituents of the hypertrophic and normal ITs were measured and compared. The Bonferroni correction was used to adjust for multiple comparisons. Qualitative assessment was performed to assess possible pathologic changes in all IT tissues.


RESULTS
The hypertrophic ITs were significantly wider. The medial mucosal layer, which thickened from a mean +/- SD of 1.39 +/- 0.28 mm to 2.53 +/- 0.56 mm (P</=.001), made the greatest contribution to the total increase in the width of the IT (64.4%). The enlargement in width of the lateral mucosal layer from 0.91 +/- 0.26 mm to 1.26 +/- 031 mm was of borderline statistical significance. The portion of the medial, lateral, and inferior layers of the lamina propria that houses inflammatory cells enlarged significantly in patients with IT hypertrophy compared with healthy control subjects. The relative proportion of the connective tissue, submucosal glands, and arteries remained unchanged, whereas that of venous sinusoids increased significantly in all aspects of the hypertrophic mucosa. Fibrosis, inflammation, and engorged venous sinusoids were noted in hypertrophic ITs, yet there was no evidence of tissue destruction.


CONCLUSIONS
Understanding the histopathology of the hypertrophic IT is imperative for the development and management of IT reduction surgery.
Berger
Gilead
G
Histopathologic Research Laboratory and Department of Otolaryngology-Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel.
Gass
Svetlana
S
Ophir
Dov
D
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology*; D015508:Nasal Obstruction / Q000473:pathology*; D011446:Prospective Studies; D014420:Turbinates / Q000473:pathology*