Effect of Septoplasty on Inferior Turbinate Hypertrophy

Abstract

To measure the effect of septoplasty on the volume of inferior turbinate in patients with a deviated nasal septum. Design: In this retrospective analysis, patients who underwent septoplasty without turbinate surgery from May 1, 2003, through April 30, 2006, were studied. The thicknesses and cross-sectional areas of mucosa and conchal bones were measured with computed tomography before the operations and at least 1 year after the operations. Setting: University hospital. Patients: A total of 20 patients who presented with a chief concern of nasal obstruction. Main Outcome Measures: The thicknesses of the medial mucosa, bone, and lateral mucosa and the cross-sectional area of turbinate before and after septoplasty were compared using the Wilcoxon signed rank test. P Ͻ.05 was considered statistically significant. Results: The medial mucosa and cross-sectional area of the inferior turbinate on the concave side of the septum were significantly decreased by septoplasty (both, P=.01), and the medial mucosa and cross-sectional area of the inferior turbinate on the convex side of the septum were significantly increased by septoplasty (P=.01). The thicknesses and cross-sectional areas of the conchal bone on the concave and convex sides of the septum were not affected by septoplasty. Conclusion: After septoplasty, inferior turbinate hypertrophy, especially in the medial mucosa, may reverse.

The Impact of Middle Turbinate Concha Bullosa on the Severity of Inferior Turbinate Hypertrophy in Patients with a Deviated Nasal Septum

“…The notion that the mucosal component of compensatory ITH is more dynamic is also supported by a study that evaluated patients who underwent septoplasty without a turbinate operation and then underwent repeat CT at least 1 year postoperatively. 10 On average, the medial mucosa of the hypertrophied inferior turbinate on the concave side of the septum preoperatively became thinner by approximately 1 mm after the septal deformity was corrected. This finding was presumed to represent the mucosal response to narrowing of the adjacent air channel caused by moving the septum back to midline.…”

“…6 ITH has been commonly described as occurring contralateral to the direction of nasal septal deviation (NSD) or, alternatively phrased, along the concave side of the septum. 2,3,[7][8][9][10][11][12][13][14] Because of this association, it has been speculated that ITH is compensatory, to create physiologically favorable nasal airflow turbulence and to protect the mucosa from excessive drying and crusting with increased air flow. In other words, the inferior turbinate may have progressively enlarged to fill the void in the nasal cavity created by the shifted midline with the undesirable result of a smaller-than-expected crosssectional area for air passage.…”

The Contribution of Computed Tomography to Nasal Septoplasty

“…In this study, in the group on whom CT was performed, in addition to septoplasty, lateral resection was performed for the patients with concha bullosa; outfracture with submucosal cauterization was done for the patients with inferior concha hypertrophy; endoscopic sinus surgery was performed for the patients with chronic sinusitis and antrochoanal polyp. 7 One patient with frontal osteoma was referred to a tertiary health care center ( Table 2). Retention cysts were not intervened, because they did not obstruct ostium.…”

Computed Tomographic Evaluation of Inferior Turbinate Hypertrophy in Adult Indo-Dravidian Patients With Deviated Nasal Septum

“…Nasal airway obstructions are often present in patients with deviated nasal septum (DNS) associated with varying degrees of concomitant inferior nasal turbinate hypertrophy (ITH) on the side contralateral to the direction of septal convexity [1][2][3][4][5][6][7]. Because of this association, it has been speculated that ITH is compensatory to create a physiologically favorable pathway for nasal airflow; the nasal mucosa could be protected from excessive drying and crusting due to increased air flow.…”