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The Histopathology of the Hypertrophic Inferior Turbinate
Gilead Berger, MD;
Svetlana Gass, MSc;
Dov Ophir, MD
Arch Otolaryngol Head Neck Surg. 2006;132:588-594.
Objective To analyze the quantitative and qualitative characteristics of the hypertrophic inferior turbinate (IT).
Design A prospective, nonrandomized, controlled, morphometric study.
Setting University-affiliated hospital.
Subjects Seventeen patients with refractory IT hypertrophy and 12 with normal ITs.
Interventions Twenty ITs were removed from patients with refractory IT hypertrophy and 14 from patients with normal ITs.
Main Outcome Measures 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.
Conclusion Understanding the histopathology of the hypertrophic IT is imperative for the development and management of IT reduction surgery.
Author Affiliations: Histopathologic Research Laboratory (Drs Berger and Ophir and Ms Gass) and Department of Otolaryngology–Head and Neck Surgery (Drs Berger and Ophir), Meir Medical Center, Kfar Saba, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Drs Berger and Ophir), Israel.
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