Morphological and histopathological study of hypertrophied inferior nasal turbinate in Egyptian patients: in clinical perspective

Ashraf Ali El-Demerdash; Essam Abdel Wanees Beheiry; Sherif Maher El-Aini; Asmaa Shams El-Dein Mohamed; Ahmed Mohamed Ibrahim Khattab

doi:10.1186/s43163-020-00024-2

Morphological and histopathological study of hypertrophied inferior nasal turbinate in Egyptian patients: in clinical perspective

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-020-00024-2 ◽

2020 ◽

Vol 36 (1) ◽

Author(s):

Ashraf Ali El-Demerdash ◽

Essam Abdel Wanees Beheiry ◽

Sherif Maher El-Aini ◽

Asmaa Shams El-Dein Mohamed ◽

Ahmed Mohamed Ibrahim Khattab

Keyword(s):

Layer Thickness ◽

Nasal Septum ◽

Inferior Turbinate ◽

Military Hospital ◽

Deviated Nasal Septum ◽

Nasal Turbinate ◽

Egyptian Patients ◽

Mucosal Layer ◽

Group A ◽

Group B

Abstract Background The inferior nasal turbinates have important role in the maintenance of nasal breathing function by providing the nasal valve mechanism necessary for the regulation of air flow through the nose. Hypertrophied inferior nasal turbinates are the second most common cause of chronic nasal obstruction. Our aim of this study is to evaluate the morphological and histopathological features of hypertrophied inferior nasal turbinate in Egyptian patients. Methods Our descriptive comparative study was carried on 30 patients presented with hypertrophied inferior nasal turbinate by clinical and radiological assessment. Patients are divided into two groups according to CT scan and endoscopic examination as group A for patients with deviated nasal septum with compensatory hypertrophied inferior nasal turbinate and group B for patients with hypertrophied inferior nasal turbinate due to allergic rhinosinusitis. Both groups underwent the same operation which partial controlled posterior inferior turbinectomy. During the period from June 2018 till May 2019, patients were selected from out-patient’s clinic of Otorhinolaryngology Department at Menoufia University Hospital and Shebin El-Kom Teaching Hospital, and Military Hospital. Results By histopathological examination of the specimens, we found out that the bony layer thickness was more prominent in group A and the mucosal layer thickness was more prominent in group B. The prominent inflammatory cells were lymphocytes in group A and eosinophils plus mast cells in group B. Conclusion The bony layer thickness should be excised during the surgical treatment of cases presented with deviated nasal septum with hypertrophied inferior turbinate where in cases of allergic rhinitis with hypertrophied inferior turbinate, the mucosal layer is enough to be excised.

Get full-text (via PubEx)

COMPARATIVE STUDY ON IMPROVEMENT OF NASAL SYMPTOMS FOLLOWING SEPTOPLASTY WITH PARTIAL INFERIOR TURBINECTOMY VS SEPTOPLASTY ALONE IN ADULTS WITH DEVIATED NASAL SEPTUM

10.36106/ujsr/5425585 ◽

2021 ◽

pp. 62-65

Author(s):

Subhadeep Chowdhury ◽

Tithi Debnath ◽

Sweta Verma

Keyword(s):

Comparative Study ◽

Nasal Obstruction ◽

Nasal Septum ◽

Tertiary Care ◽

Inferior Turbinate ◽

Deviated Nasal Septum ◽

Nose Scale ◽

Nasal Symptoms ◽

Group A ◽

Group B

BACKGROUND: Nasal obstruction is a common presenting symptom which otolaryngologists encounter in daily clinical practice. One of the most common cause of nasal obstruction is deviated nasal septum(DNS). DNS to one side is associated with overgrowth of inferior turbinate on the contralateral side. Septoplasty alone or septoplasty with inferior turbinate reduction is the mode of treatment but that depends upon the decision of the operative surgeon. In this study we aim to collect data and come to a conclusion as to which surgery is benecial for the patients. AIMS AND OBJECTIVES: (1) To compare the symptomatic improvement of nasal symptoms following septoplasty with partial inferior turbinectomy versus septoplasty alone by NOSE Scale. (2) To corroborate the subjective ndings of NOSE Scale by rhinomanometry and nasal endoscopy. METHODOLOGY: A prospective and comparative study was done on 60 patients over a period of 1 year in a tertiary care centre. Patients were alternatively divided into two surgical groups Group A- septoplasty with partial inferior turbinectomy and Group B- septoplasty alone. Nasal Obstruction Symptom Evaluation(NOSE) was used for subjective evaluation of nasal symptoms. Rhinomanometry was used as a tool for objective evaluation of symptoms. Data was analysed using tables, graph and percentage and test of signicance. Post operative improvement RESULTS: following both group A septoplasty with partial inferior turbinectomy and group B Septoplasty alone was signicant at post op 1,3 and 6 months respectively. When both groups were compared those undergoing partial inferior turbinectomy with septoplasty had highly signicant results by NOSE scale as well as rhinomanometry and endoscopy. This study showed tha CONCLUSION: t hypertrophied turbinate need to be addressed in chronic cases of nasal obstruction with deviated nasal symptom with contralateral turbinate hypertrophy. Thus we can conclude that partial inferior turbinectomy should be done in addition to septoplasty as it is a highly effective modality for treatment of nasal obstruction in patients of nasal obstruction in patients with deviated nasal septum.

Get full-text (via PubEx)

COMPARISON OF MICRODEBRIDER - ASSISTED TURBINOPLASTY VERSUS ENDOSCOPIC PARTIAL TURBINECTOMY IN CASES OF INFERIOR TURBINATE HYPERTROPHY IN ALLERGIC RHINITIS PATIENTS

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-3.4121 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S598-602

Author(s):

Muhammad Ahmed Khan ◽

Faiz Ul Hassan Nawaz ◽

Muhammad Tahir ◽

Hina Mazhar ◽

Muhammad Dawood ◽

...

Keyword(s):

Allergic Rhinitis ◽

Nasal Obstruction ◽

Inferior Turbinate ◽

Military Hospital ◽

Turbinate Hypertrophy ◽

Quasi Experimental ◽

Group A ◽

Group B ◽

Inferior Turbinate Hypertrophy ◽

Age Range

Objective: To compare microdebrider-assisted turbinoplasty versus endoscopic partial turbinectomy in cases of inferior turbinate hypertrophy in allergic rhinitis patients in terms of relief/improvement of nasal obstruction, post operative bleeding, crusting and synechie formation. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital Mardan and Combined Military Hospital Malir, from Jan 2019 to Jan 2020. Methodology: A total of 90 patients of allergic rhinitis with severe nasal obstruction due to bilateral inferior turbinate hypertrophy fulfilling the inclusion exclusion criteria were selected. Cases were randomly divided into two groups of 45 each. Group A cases underwent microdebrider assisted turbinoplasty and Group B cases underwent partial turbinectomy via endoscpic approach. They were comparedin terms of post op bleeding, relief of nasal obstruction, post op crusting & synechie/adhesions. All the data was entered on SPSS-17 and analyzed. Results: Out of 90 cases, there were 43 (47.8%) females and 47 (52.2%) males with age range from 15-65, mean age 37.68 ± 11.56 Years. There was only 1 case of post op bleeding after microdebrider assisted turbinoplasty requiring nasal packing in contrast to 6 cases of post op bleeding after endoscopic partial turbinectomy. On one month post op visit, there was no case of nasal crusting in turbinoplasty group in contrast to 7 of mild and 1 of moderate crusting & 3 synechie/adhesions in endoscopic partial turbinectomy group. Conclusion: Microdebrider-assisted turbinoplasty is associated with less post operative bleeding and synechie formation as compared to endoscopic turbinectomy.

Get full-text (via PubEx)

A comparative study of endoscopic versus conventional septoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203205 ◽

2020 ◽

Vol 6 (8) ◽

pp. 1490

Author(s):

Ramniwas Dhaka ◽

Pooja Arya ◽

Deep Chand ◽

Vivek Samor ◽

Ramchander Bishnoi ◽

...

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Objective Assessment ◽

Posterior Part ◽

Sinus Surgery ◽

Deviated Nasal Septum ◽

Endoscopic Septoplasty ◽

Surgery Patient ◽

Group A ◽

Group B

Background: Deviated nasal septum is one of the common causes of nasal obstruction. Correction of deviated nasal septum has been performed by a variety of techniques of which Septoplasty is the most popular one. With the advent of endoscopes and their successful use in endoscopic sinus surgery endoscopes have been tried in septoplasty for better visualization of posterior part of septum and do the surgery more precisely and with less complication as compare to conventional method. The objectives of the study were to compare the outcomes of conventional and endoscopic septoplasty, to evaluate the advantages, disadvantages and complications of both endoscopic and conventional septoplasty.Methods: It was a prospective observational study conducted on 50 patients with deviated nasal septum, who presented to ENT department of SPMC, Bikaner, patients were randomly divided equally in two groups for conventional and endoscopic septoplasty respectively. Data collected on a prestructured proforma and results analysed. Results: The study included 50 cases. Postoperatively significant relief from the symptoms of nasal obstruction (82%) in group A and (96%) group B, was seen. In objective assessment at the end of 3 months of surgery, patient had persistent posterior deviation 24% in group A and 3% in group B, spur 12% in group A and 0% in group B.Conclusions: Endoscopic septoplasty has an obvious edge over the conventional approach due to better illumination which enables to identify the pathology accurately, excise the deviated part of septum precisely and realignment of the cartilage for best results.

Get full-text (via PubEx)

A comparative study of effect of deviated nasal septum on nasal mucociliary clearance and to comprehend the effect of septal and turbinate surgeries on restoring the mucociliary clearance

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20181868 ◽

2018 ◽

Vol 4 (3) ◽

pp. 764

Author(s):

Smitha B. C. Chandra ◽

Kiran Bylappa

Keyword(s):

Nasal Septum ◽

Mucociliary Clearance ◽

Concave Side ◽

Control Group ◽

Convex Side ◽

Clearance Time ◽

Deviated Nasal Septum ◽

Group A ◽

Group B ◽

Nasal Mucociliary Clearance

Background: One of the important functions of nose is mucociliary transport by its epithelium. Any structural abnormalities of nose like deviated nasal septum, turbinate hypertrophy and polyps can easily damage the mucociliary clearance. This can lead to increased inflammation leading to osteomeatal complex obstruction and sinusitis. The purpose of the study is to determine the nasal mucociliary clearance time (NMC) in patients with deviated nasal septum. And to compare the changes in nasal mucociliary clearance time before and after septoplasty and septoplasty with turbinectomy.Methods: Nasal mucociliary clearance time was measured preoperatively in patients with deviated nasal septum on concave and convex side. Post operatively it was again recorded after septoplasty in group A and septoplasty with turbinectomy in group B. These values were compared with the control group C. Results: Postoperatively group A patients NMC time was 11.11±2.76 on convex side, 14.01±2.39 on concave side. In group B patients NMC time was 11.18±1.91 on convex side and 12.62±1.42 on concave side.Conclusions: Nasal septal deviation and hypertrophied inferior turbinates can cause considerable impairment of nasal mucociliary clearance. Septoplasty combined with partial inferior turbinectomy of compensatory hypertrophied inferior turbinate on concave side preserves the normal NMC mechanism on both the sides of nasal cavity than just septoplasty.

Get full-text (via PubEx)

COMPARATIVE STUDY BETWEEN CONVENTIONAL INFERIOR TURBINECTOMY AND ENDOSCOPIC INFERIOR TURBINOPLASTY FOR TREATMENT OF INFERIOR TURBINATE HYPERTROPHY

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-3.4738 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S617-21

Author(s):

Atif Rafique ◽

Maqbool Raza ◽

Shahid Farooq Khattak ◽

Muhammad Ali ◽

Khalid Azam ◽

...

Keyword(s):

Age Groups ◽

Inferior Turbinate ◽

Military Hospital ◽

Turbinate Hypertrophy ◽

Post Operative Pain ◽

Group A ◽

Group B ◽

Inferior Turbinate Hypertrophy ◽

Comparative Prospective Study ◽

Nose And Throat

Objective: To compare efficacy of endoscopic turbinoplasty versus conventional inferior turbinectomy for hypertrophy of inferior turbinate. Study Design: Comparative prospective study. Place and Duration of Study: Ear, Nose and Throat (ENT) Department Combined Military Hospital (CMH) Multan, from Jun 2019 to May 2020. Methodology: This study comprised of 50 patients of various age groups and both genders. Patients were grouped into two groups A and B, each group having 25 patients through random sampling. Patients in group A had endoscopic turbinoplasty whereas patients in group B had partial turbinectomy through conventional surgical method. Patients were followed regularly in both groups and were inspected postoperatively at 2 weeks, after 1 month and after 3 months. Results: Patients who underwent Endoscopic turbinoplasty experienced less pain (p˂0.05) postoperatively at 2 weeks compared to conventional surgical turbinectomy. In addition, these patients showed statistically significant healing and reduced crusting at 1 month postoperatively. At 3 months post operatively all patients had healed completely as opposed to only 72% with surgical turbinectomy. Conclusion: Endoscopic turbinoplasty is more effective than conventional surgical technique for inferior turbinate hypertrophy as it leads to less post-operative pain, reduced nasal crusting and earlier healing.

Get full-text (via PubEx)

Comparison results of nasal septum suturing and nasal packing following septoplasty

Romanian Journal of Rhinology ◽

10.2478/rjr-2019-0012 ◽

2019 ◽

Vol 9 (34) ◽

pp. 97-99

Author(s):

Ali Asghar Peyvandi ◽

Mahbobeh Oroei ◽

Shahrokh Khoshsirat

Keyword(s):

Postoperative Complications ◽

Nasal Septum ◽

Nasal Packing ◽

Patient Comfort ◽

Deviated Nasal Septum ◽

Respiratory Problems ◽

Comparison Results ◽

Group A ◽

Group B ◽

Suturing Techniques

Abstract BACKGROUND. Septoplasty is routinely used to resolve the deviated nasal septum. To obviate postoperative complications, some surgeons pack both nasal cavities and some other use suturing techniques after septoplasty. OBJECTIVE. To investigate the efficacy of septal suturing and packing in patients post-septoplasty. MATERIAL AND METHODS. This study was conducted in the Department of Otorhinolaryngology, Loghman Hakim, Tehran, Iran. 146 patients aged 17 years and above were enrolled for septoplasty. Septal suture was performed in 73 patients (group A) and nasal packing in the other 73 patients (group B). The principal outcomes in terms of bleeding, pain, respiratory problems, septal hematoma, adhesion and perforation were measured over a post-operative follow-up period. RESULTS. A total of 146 patients, 74% female and 26% male, were enrolled. There were statistically significant differences between the two groups with respect to respiratory problems and patient comfort (p<0.001). The patients in both groups had no septal perforation. CONCLUSION. Septoplasty using trans-septal suturing without packing can be safe and suitable to prevent or minimize postoperative complications.

Get full-text (via PubEx)

A comparative study of endoscopic verses conventional septoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20210507 ◽

2021 ◽

Vol 7 (3) ◽

pp. 417

Author(s):

Radeif Shamakhi ◽

Wael A. Juribi ◽

Ali H. Alzarei ◽

Musleh H. Mubaraki

Keyword(s):

Surgical Procedure ◽

Nasal Septum ◽

Conventional Technique ◽

Sinus Surgery ◽

Age Group ◽

Deviated Nasal Septum ◽

Endoscopic Septoplasty ◽

Group A ◽

Group B ◽

Excellent Tool

Background: Septoplasty is the surgical procedure for the correction of a deviated nasal septum. It can be achieved either with an endoscopic or a conventional approach. Endoscope allows better visualization and magnification, helps in enhancing surgical procedure accuracy and there is also no need for overexposure, excessive septal anatomy manipulation, osseocartilaginous disarticulation of the nasal septum and further resection. Endoscopic septoplasty is not only used to address symptomatic nasal obstruction, but also to improve visualization in sinus surgery. This study was conducted to compare intra operative bleeding of the two techniques in treatment of deviated nasal septum.Methods: The present study was conducted in the department of otorhinolaryngology, Prince Mohammed hospital and Aseer central hospital. The study was conducted in 30 patients having symptomatic DNS, in the age group of 18-50 years after obtaining their consent. The patients were randomly divided into two groups of 15 patients each. Group A (n=15) underwent endoscopic septoplasty and group B (n=15) underwent conventional septoplasty under general anesthesia. The two groups were compared regarding intra operative bleeding of surgery.Results: In conventional septoplasty there is more bleeding during surgery but in Endoscopic septoplasty the bleeding is less during surgery.Conclusions: The endoscopic septoplasty offers an alternative to conventional technique with superior visualization, excellent illumination and excellent tool for teaching. It preferred for posterior deviation, whereas conventional septoplasty is still preferred for anterior deviation.

Get full-text (via PubEx)

A prospective study of deviated nasal septum giving rise to other ENT pathologies

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200142 ◽

2020 ◽

Vol 6 (2) ◽

pp. 303

Author(s):

S. Ranga Pradheep Kumar ◽

Seema V. Patel

Keyword(s):

Prospective Study ◽

Nasal Obstruction ◽

Nasal Septum ◽

Septal Deviation ◽

Deviated Nasal Septum ◽

Female Ratio ◽

Nasal Symptoms ◽

Group A ◽

Group B ◽

A Prospective Study

Background: The deviated nasal septum (DNS) is a commonly occurring clinical condition that often causes nasal obstruction. This study, included two groups of subjects 100 each. The group A consists of subjects having DNS with nasal symptoms. The group B consists of subjects having DNS without nasal symptoms but with ear and throat symptoms. The present study makes an effort to review the types and its associated pathology.Methods: A prospective study was carried out in the Department of ENT, Government Medical College and Hospital, Nagpur from September 2016 to October 2018. Data was collected and analysed. Results: The mean age 31.17 years in group A and 30.07 years in group B, with male to female ratio of 1.17:1 in group A and 1.04:1 in group B. Left-sided septal deviation was more common than right-sided deviation. The most common symptoms in group A was nasal obstruction (94%) and in group B was otorrhoea (80%)."C" shaped DNS was the most common type in both the groups. Out of total 200 subjects comprising both the groups, 70 (35%) subjects had significant sinonasal disease, 138 (69%) subjects had ear pathology, 69 (34.5%) had Eustachian tube dysfunction, 35 (17.5%) had throat pathology. In this study, “S” shaped deviation was more prone to be associated with ENT pathology.Conclusions: “S” shaped DNS was maximally associated with sinonasal pathology and there was a high correlation between the side of septal deviation to the side of ear pathology, particularly in asymptomatic DNS.

Get full-text (via PubEx)

Clinical outcome following septoplasty with or without inferior turbinate reduction

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203567 ◽

2020 ◽

Vol 6 (9) ◽

pp. 1651

Author(s):

Amrit Raj Sharma ◽

Shalini Jain ◽

Kanwar Sen ◽

Ankur Gupta

Keyword(s):

Clinical Outcome ◽

Nasal Septum ◽

Inferior Turbinate ◽

Compensatory Hypertrophy ◽

P Value ◽

Nasal Airway ◽

Septal Surgery ◽

Group A ◽

Group B ◽

Turbinate Reduction

Background: Deviation of nasal septum towards one side is often associated with over growth of inferior turbinate, which occupies expansive space of contralateral nasal cavity. The enlargement of inferior turbinate can be due to mucosal elements or bony expansion. Many surgeons are of the belief if septoplasty is done, compensatory hypertrophy regresses on its own. There are others who argue that these changes are not spontaneously reversible and should be corrected in conjunction with nasal septal surgery. Otherwise surgery may relieve the obstruction on one side of nose but leave other side of obstructed because of relocation of septum towards hypertrophied turbinate.Methods: A prospective interventional randomized comparative study is carried out from 1st November 2017 to 31th March 2019, with a sample size of 40 patients. Patients were divided in two surgical groups; group A, with conventional septoplasty done and group B, with reduction of inferior turbinate along with conventional septoplasty done. Post operatively patients’ symptoms will be evaluated using nasal obstructions evaluation scale (NOSE) and nasal airway with nasal endoscopy at 1, 3 and 6 months, and compared with preoperative findings.Results: Data is analyzed using percentage graph and tables. The comparisons of NOSE score at 1, 3- and 6-months interval showed the p value of 0.001 which was significant. Also comparison of two groups with NOSE score showed significant improvement in group B.Conclusions: The study shows that hypertrophied turbinate need reduction along with septoplasty in cases of long standing nasal obstruction.

Get full-text (via PubEx)

A comparative study of endoscopic versus conventional septoplasty: an analysis of 50 cases

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20174330 ◽

2017 ◽

Vol 3 (4) ◽

pp. 1046

Author(s):

Sagar Chandra ◽

Nitish Baisakhiya

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Posterior Part ◽

Surgical Correction ◽

Nasal Discharge ◽

Deviated Nasal Septum ◽

Nasal Endoscope ◽

Endoscopic Septoplasty ◽

Group A ◽

Group B

Background: Nasal obstruction is the most common complaint in ENT practice. Surgical correction of deviated nasal septum has been performed by a variety of techniques of which sub mucous resection and Septoplasty procedures of surgical correction of nasal septum play a prime role in management of patients of nasal obstruction. Nasal endoscope is very useful tool to visualize posterior part of septum and do the surgery more precisely and with less complication as compare to conventional method. The objectives of the study were to compare the outcomes of conventional and endoscopic septoplasty, to evaluate the advantages, disadvantages and complications of both endoscopic and conventional septoplastyMethods: 50 cases (between (Oct. 2014 - March 2016) of deviated nasal septum selected in this prospective study and they were randomly divided equally in 2 groups for endoscopic (A) and conventional (B) septoplasty respectively. Results: The study included 50 cases. Majority of patients in this study were males 84% (n=42) and 16% (n=18) were female. 46% (n=23) patients had DNS to right side and 54% (n=27) patients had left side, anterior deviation (48%). C and S shaped deviations (14%). Spur was present in 22% (n=11) of cases and 10% (n=5) patients presented with thickening. After completing 2 months of follow up 92% (n=23) of group A and 88% (n=22) of group B were relieved from nasal discharge, while nasal obstruction was absent in 96% (n=24) patients of group A and 80% (n= 20) of group B. 4% cases (n=1) in endoscopic septoplasty was having persistent deviated nasal septum and 16% (n=4) patients of conventional septoplasty belong to this group.Conclusions: Endoscopic septoplasty has an obvious edge over the conventional approach due to better illumination which enables to identify the pathology accurately, excise the deviated part of septum precisely and realignment of the cartilage for best results.

Get full-text (via PubEx)