A new insight for evaluation of the inferior turbinate with ultrasound elastography.
OBJECTIVE
There are diseases that affect the stroma of the inferior turbinate and many surgical interventions that alter it. However, an objective method that can evaluate the turbinate's stromal structure in detail has not been defined yet. The primary aim of this study was to investigate the effectiveness and reliability of ultrasound elastography for objective evaluation of the inferior turbinate stroma and define the most suitable elastographic technique.


METHODS
Twenty inferior turbinates in 10 healthy participants were included. Five of the participants (50%) were male, and 5 (50%) were female, with a mean age ± SD of 28.3 ± 3.2 years (range, 26-35) years. To obtain reliable and reproducible results, elastography was performed twice, 3 days apart, with and without a topical decongestant to evaluate the effects of the nasal cycle and mucosal edema. Two previously described valid elastographic outcome measures were reevaluated for the inferior turbinate. The tissue strain ratio and sound wave propagation speed were calculated for each measurement.


RESULTS
Median propagation speeds without and with the decongestant for the first and second measurements were 2.125 (interquartile range [IQR], 0.85), 2.175 (IQR, 0.53), 2.520 (IQR, 0.79), and 2.555 (IQR, 0.53) m/s, respectively. Median turbinate stroma-to-subcutaneous tissue strain ratios without and with the decongestant for the first and second measurements were 1.402 (IQR, 0.96), 0.942 (IQR, 0.24), 1.035 (IQR, 0.98), and 1.427 (IQR, 1.68).


CONCLUSIONS
We suggest that elastography is a reliable and reproducible method that is not substantially affected by mucosal edema. It is a novel technique that can evaluate the inferior turbinate stroma and might be used in concordance with other objective functional techniques such as acoustic rhinometry. Therefore, it can be used in further studies regarding diagnosis of turbinate diseases and objective evaluation of previous surgical treatments.
Departments of Radiology (E.K.) and Otolaryngology (S.G., G.T., K.Ö., R.M.), Ege University Medical School, Izmir, Turkey.
Erkan
E
Kısmalı
Departments of Radiology (E.K.) and Otolaryngology (S.G., G.T., K.Ö., R.M.), Ege University Medical School, Izmir, Turkey.
Sercan
S
Göde
Departments of Radiology (E.K.) and Otolaryngology (S.G., G.T., K.Ö., R.M.), Ege University Medical School, Izmir, Turkey gokselturhal@gmail.com.
Göksel
G
Turhal
Departments of Radiology (E.K.) and Otolaryngology (S.G., G.T., K.Ö., R.M.), Ege University Medical School, Izmir, Turkey.
Kerem
K
Öztürk
Departments of Radiology (E.K.) and Otolaryngology (S.G., G.T., K.Ö., R.M.), Ege University Medical School, Izmir, Turkey.
Midilli
M
Rașit
D000287:Administration, Topical; D000328:Adult; D055119:Elastic Modulus / Q000187:drug effects / Q000502:physiology; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D014663:Nasal Decongestants / Q000008:administration & dosage; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013314:Stress, Mechanical; D014420:Turbinates / Q000000981:diagnostic imaging* / Q000187:drug effects
D014663:Nasal Decongestants
elastography; head and neck ultrasound; hypertrophy; inferior turbinate