The septal tubercle: the state of the problem

Abstract

The septal tubercle is considered to be a thickened area of the nasal septum, which is located above the lower nasal concha and in front of the middle nasal concha. Taking into account its histological structure and location in the distal segment of the internal nasal valve, it is located and structured for secretory function and vasoactive regulation of the respiratory air flow. These histologically rich tissues with glandular elements are well adapted to the possible dryness that occurs under the influence of intense air flow during breathing, and the existence of a certain number of venous sinusoids of the blood confirms the connection with part of the extensive vascular tissues in the nasal cavity. It is believed that the tubercle of the nasal septum is more pronounced in patients with chronic inflammation of the sinonasal region, for example, with chronic allergic rhinitis or chronic rhinosinusitis. There is currently no consensus on the issue of surgery of the nasal septum body. Due to the lack of consensus among practitioners, many surgeons do not routinely perform operations on this structure and consider the surgical intervention too aggressive, and the effect on nasal obstruction is insignificant. However, according to the presented studies, the results of surgical reduction of soft tissues of the enlarged septal tubercle in the treatment of nasal obstruction using radiofrequency ablation, coblation or microdebrider seem promising, which requires additional study of this issue during long-term follow-up.