Evaluation of the Inferior Turbinate in Patients With Deviated Nasal Septum by Using Computed Tomography

Abstract

The present study uncovers the dimensions and composition of the inferior turbinate with compensatory hypertrophy in patients with nasal septum deviation. The findings support the decision to excise the inferior turbinate bone at the time of septoplasty, because of the significant bony and mucosal expansion.

The Impact of Middle Turbinate Concha Bullosa on the Severity of Inferior Turbinate Hypertrophy in Patients with a Deviated Nasal Septum

“…CT has been used as an alternative form of in vivo assessment for ITH associated with NSD by acquiring different measurements of bone and soft-tissue components of the inferior turbinate and comparing these results internally with the contralateral side or exter- nally with a control population. 8,9,[11][12][13] In general, these CT data support the findings of acoustic rhinometry that compensatory ITH arises from increased bone and mucosal thickness. Additionally, as measured by distance or angle, the inferior turbinate on the concave side of a deviated septum projects farther medially into the nasal cavity.…”

“…3 We chose the coronal image used for assessment through the level of the maxillary sinus ostium to include the concha bullosa, while noting that the contributions of bone and mucosa to ITH have been validated for the middle third of the inferior turbinate. 8,9,12 The precise mechanism underlying the development of compensatory ITH in NSD remains unclear, but there is evidence to suggest a long-standing acquired process. Aslan et al 12 stratified…”

“…6 ITH has been commonly described as occurring contralateral to the direction of nasal septal deviation (NSD) or, alternatively phrased, along the concave side of the septum. 2,3,[7][8][9][10][11][12][13][14] Because of this association, it has been speculated that ITH is compensatory, to create physiologically favorable nasal airflow turbulence and to protect the mucosa from excessive drying and crusting with increased air flow. In other words, the inferior turbinate may have progressively enlarged to fill the void in the nasal cavity created by the shifted midline with the undesirable result of a smaller-than-expected crosssectional area for air passage.…”

Computed Tomographic Evaluation of Inferior Turbinate Hypertrophy in Adult Indo-Dravidian Patients With Deviated Nasal Septum

“…Nasal airway obstructions are often present in patients with deviated nasal septum (DNS) associated with varying degrees of concomitant inferior nasal turbinate hypertrophy (ITH) on the side contralateral to the direction of septal convexity [1][2][3][4][5][6][7]. Because of this association, it has been speculated that ITH is compensatory to create a physiologically favorable pathway for nasal airflow; the nasal mucosa could be protected from excessive drying and crusting due to increased air flow.…”

The nasal septum deviation index (NSDI) based on CBCT data

“…Together with NSD, a hypertrophy of the turbinates, opposed to septal convexity, is often noticed. 1,2 Diagnostic investigations currently used for this pathology are anterior rhinoscopy, endoscopy, multislice CT and MR, which allow a good evaluation of the entity and position of NSD. [3][4][5][6][7][8] In particular, pre-operative CT scan of the paranasal sinuses is often performed before septoplasty, in order to evaluate nasal anatomy, to find concomitant sinonasal pathologies and to reduce surgical failure.…”