Histopathological study of compensated inferior turbinate hypertrophy and its hypertrophy in allergic rhinitis

Abstract

Background Nasal obstruction resulting from inferior turbinate hypertrophy (ITH) is a common complaint in otorhinolaryngology. Objective Differentiation between compensatory ITH due to deviated nasal septum (DNS) and ITH due to allergic rhinitis in order for the surgeon to choose the proper surgical techniques. Patients and methods This study included 60 patients aged between 18 and 50 years (18 men and 12 women). They suffered from ITH as proven by history and endoscopic examination. Patients were subdivided into two groups. Group A: included 30 patients who were presented by compensated ITH due to DNS. Skin prick test was done for all patients of this group to exclude allergic patients. Group B: included 30 patients who were presented by bilateral ITH due to allergic rhinitis. All patients underwent endoscopic partial inferior turbinectomy under general anesthesia with or without septoplasty, taking care to include all three layers of the turbinate. The turbinate specimens were processed in a standard manner in the Department of Pathology, and slides were prepared, and examined histopathologically and micrometrically. Results The mean thickness of the bony layer of ITH patients in group A was 6.50±1.75 mm, whereas its thickness in group B was 2.25±±1.25 mm with a statistically significant P value=0.001, while the mean thickness of the medial mucosal layer of ITH patients of group A was 2.25±0.5 mm, whereas its thickness (group B) was 4.25±0.75 mm with statistically nonsignificant P value (0.06). Conclusion The bony layer contributes to the main thickness of compensatory ITH due to DNS because of the significant bony expansion; so, it should be a target of surgery, while surgical techniques that aim to remove the mucosa, leaving the bony part of the turbinate in allergic rhinitis are suitable for such patients.