Introduction The inferior turbinate (IT) is the most susceptible turbinate to enlargement causing nasal obstruction. The common belief ascribes most of the enlargement of the IT to mucosal elements. Objective This study aimed to investigate the detailed computed tomography (CT) measurement of the IT in asymptomatic adult by determining the thickness of both the non-bony (mucosa) and bony parts and their relation to nasal air space in different related areas of the nose. Methods We included in the study paranasal CT scans of 108 individuals (216 IT) that had no paranasal pathology. We acquired axial images with multiplanar reformates to obtain delicate details in coronal and sagittal planes for all subjects. We took separate measurements of the thickness of the medial mucosa, bones, and lateral mucosa of the IT on the anterior and posterior portions of ITs. We also measured the air space of the nasal cavity between the septum and IT anteriorly and posteriorly. Results The difference in the air space between nasal septum, anterior and posterior ends of IT was extremely statistically significant (P < 0.0001). The thickness of the medial mucosa was extremely significantly more than the lateral mucosa width (P < 0.0001). There was no significant difference in length of IT at both sides ( p = 0.5781). Conclusion The detailed CT measurement of the IT in normal adult is an easy and novel measurement. This study lays the foundation for CT measurement of IT for further work that can describe changes in IT measures after turbinate surgery.
Introduction Surfactant protein A (SP-A) exhibits antimicrobial properties and interacts with a variety of respiratory tract pathogens. Objective The objective of this study was to detect the presence of SP-A and measure its alterations in chronic rhinosinusitis (CRS) and primary atrophic rhinitis (PAR) versus healthy controls. Methods Inferior turbinate and sinus mucosal biopsies were taken from 30 patients with CRS, 30 patients with PAR, and 20 healthy controls. Immunohistochemical staining for SP-A and polymerase chain reaction (PCR) amplification of SP-A messenger RNA were performed on nasal tissue samples. Results Immunostaining localized SP-A to the mucosa and submucosal glands in CRS specimens but failed to localize it in PAR specimens. Quantitative PCR showed a high, statistically significant increase in the SP-A levels of patients with CRS when compared with controls (p < 0.0001) and also demonstrated a significant reduction of SP-A in patients with PAR compared with controls (p < 0.005). Conclusion SP-A is significantly increased in CRS and decreased significantly in PAR and appears to be expressed by respiratory epithelial cells and submucosal glandular elements of the sinonasal mucosa. The potential therapeutic applications of surfactant in the enhancement of mucociliary clearance need to be studied.
Objective: Otoscopic examination is the best method for diagnosis of cholesteatoma which treated by explorative surgery. The need for pre-operative imaging studies is controversial. This study assesses the accuracy and usefulness of a pre-operative high-resolution CT scan in depicting the status of the middle ear structures in the presence of cholesteatoma. Patients and Methods: the surgical findings of 88 patients with acquired cholesteatoma were compared with the pre-operative CT findings in this prospective study. The following were analyzed: diagnostic features of cholesteatoma on CT, status of the middle ear structures (ossicles, facial nerve canal, bony labyrinth, tegmen tympani and scutum) and extension of the disease to the sinus tymapni and facial recess. Results: eighty-three (94.3%) cases had the two radiological features characteristic for cholesteatoma (a) a location typical for cholesteatoma in the epitympanum and mastoid antrum (b) bony erosion. The radio-surgical agreement was excellent for the malleus (Kappa statistics, K= 0.96), stapes (0.91), bony labyrinth (0.94), tegmen tympani (0.82) and scutum (1), good for the incus (0.75), but poor for the facial nerve canal (0.39). The scan accurately predicted the extension of the disease to the sinus tympani and facial recess. Conclusion: High-resolution CT scan is an important investigative tool prior to cholesteatoma surgery.There is good to excellent radio-surgical correlation in cholesteatoma for most middle ear structures except for the integrity of the facial canal. The scan alerts the surgeon to asymptomatic complication of the disease.
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