The inferior turbinate: An autonomic organ

Smith, Drew; Brook, Christopher; Virani, Shahab; Platt, Michael P.

doi:10.1016/j.amjoto.2018.08.009

Cited by 28 publications

(16 citation statements)

References 79 publications

(88 reference statements)

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“…Previous studies have demonstrated that, histologically, the ITs contain a stroma filled with arteriovenous channels. 6 These vessels are regulated by the autonomic nervous system, which facilitates their presumed role in regulation of nasal airflow, humidification of inspired air, thermoregulation, and filtration of particulate matter such as dust or pollen.…”

Section: Introductionmentioning

confidence: 99%

Isolated Topical Decongestion of the Nasal Septum and Swell Body Is Effective in Improving Nasal Airflow

Wong

Deboever

Chong

et al. 2020

Am J Rhinol�Allergy

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Background Topical nasal decongestant sprays are used commonly in routine otolaryngology practice to reduce the symptoms of nasal airway obstruction (NAO) through vasoconstriction, thereby reducing the bulk of vasoerectile tissue and increasing nasal airflow. Such tissue is found predominantly on the lateral wall of the nose within the inferior turbinates (ITs), but recent evidence suggests that it may also be found medially within the nasal septal swell body (SSB). Objective To determine whether isolated topical decongestion of the medial nasal wall, targeting the SSB, is as effective as isolated decongestion of the lateral nasal wall, targeting the IT, in maximizing nasal patency. Methods A double-blinded, randomized controlled, crossover study was performed investigating the effect of decongestion of the lateral nasal wall or septum in isolation on nasal airflow. Isolated decongestion was performed by placing a cottonoid, soaked in oxymetazoline and attached to a silastic sheet, into the nasal cavity randomly facing either the septum or lateral nasal wall, bilaterally. Anterior rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow (PNIF), and subjective patient-reported outcomes (Sinonasal Outcome Test (SNOT-22) and Nasal Obstruction Symptom Evaluation (NOSE) scores) were recorded at baseline and postdecongestion. Decongestion of the alternate site was then performed at a later date. Results A total of 20 healthy volunteers (30% females, mean age 26.6 ± 3.8 years) were recruited. Improvements in nasal obstruction and SNOT-22 scores were found following decongestion of the septum compared with baseline (mean difference: 0.82, t = 2.32, P = .04; mean difference: 3.30, t = 2.50, P = .04, respectively). Improvements in mean inspiratory flow, minimal cross-sectional area, volume, and PNIF were also demonstrated. Conclusion This study suggests that the SSB contains erectile tissue that responds to topical decongestant therapy in a similar manner to IT tissue. The SSB may represent a novel target in surgery for NAO.

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Section: Introductionmentioning

confidence: 99%

Isolated Topical Decongestion of the Nasal Septum and Swell Body Is Effective in Improving Nasal Airflow

Wong

Deboever

Chong

et al. 2020

Am J Rhinol�Allergy

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“…The density of vasoactive structures may indicate that, like turbinates, 9 the septal swell body may be involved in the regulation of nasal airflow, air humidification and temperature regulation. 10 It may also follow that, similar to the turbinates, the thickening, fibrosis and chronic inflammation of the septal swell body, caused by pathology such as allergy or altered immunology, may impact its morphology leading to nasal airflow obstruction. 11…”

Section: Introductionmentioning

confidence: 99%

Physiological changes in the size of the septal swell body correlate with changes in inferior turbinate size

et al. 2020

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ObjectiveThe nasal septal swell body is a normal anatomical structure located in the superior nasal septum anterior to the middle turbinate. However, the impact of the septal swell body in nasal breathing during normal function and disease remains unclear. This study aimed to establish that the septal swell body varies in size over time and correlates this with the natural variation of the inferior turbinates.MethodConsecutive patients who underwent at least two computed tomography scans were identified. The width and height of the septal swell body and the inferior turbinates was recorded. A correlation between the difference in septal swell body and turbinates between the two scans was performed using a Pearson's coefficient.ResultsA total of 34 patients (53 per cent female with a mean age of 58.3 ± 20.2 years) were included. The mean and mean difference in septal swell body width between scans for the same patient was 1.57 ± 1.00 mm. The mean difference in turbinate width between scans was 2.23 ± 2.52 mm. A statistically significant correlation was identified between the difference in septal swell body and total turbinate width (r = 0.35, p = 0.04).ConclusionThe septal swell body is a dynamic structure that varies in width over time in close correlation to the inferior turbinates. Further research is required to quantify its relevance as a surgical area of interest.

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“…Su estructura plegada puede aumentar la superficie mucosa endonasal hasta 200 cm 2 y contribuye en varios aspectos de la función nasal, como la humidificación y termorregulación del aire inspirado, la regulación del flujo nasal y la producción de secreciones. Para esto consta de un tejido eréctil ricamente vascularizado y una compleja regulación autonómica 14,15 .…”

Section: Cirugía De Los Cornetes Inferioresunclassified

Rinoplastía y rinoseptoplastía funcional: Mejorando la función nasal más allá de la cirugía del tabique y los cornetes nasales

2020

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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The inferior turbinate: An autonomic organ

Cited by 28 publications

References 79 publications

Isolated Topical Decongestion of the Nasal Septum and Swell Body Is Effective in Improving Nasal Airflow

Isolated Topical Decongestion of the Nasal Septum and Swell Body Is Effective in Improving Nasal Airflow

Physiological changes in the size of the septal swell body correlate with changes in inferior turbinate size

Rinoplastía y rinoseptoplastía funcional: Mejorando la función nasal más allá de la cirugía del tabique y los cornetes nasales

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