A prospective histopathological analysis of the inferior turbinate: which functional parts should be preserved during turbinate surgery?

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Brazilian Journal of Otorhinolaryngology Pub Date : 2024-08-09 DOI:10.1016/j.bjorl.2024.101486

Salma Saud AlSharhan , Norah Mohammad AlNafea , Mona Mohammad Ashoor , Wasan Fahad AlMarzouq , Salwa ALRashed AlHumaid , Nada Abdallah ALBahrani , Areej Manssour Al Nemer , Reem S. AlOmar , Hussain Jawad Aljubran

{"title":"A prospective histopathological analysis of the inferior turbinate: which functional parts should be preserved during turbinate surgery?","authors":"Salma Saud AlSharhan , Norah Mohammad AlNafea , Mona Mohammad Ashoor , Wasan Fahad AlMarzouq , Salwa ALRashed AlHumaid , Nada Abdallah ALBahrani , Areej Manssour Al Nemer , Reem S. AlOmar , Hussain Jawad Aljubran","doi":"10.1016/j.bjorl.2024.101486","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Inferior turbinate (IT) hypertrophy-induced chronic nasal obstruction is one of the most common problems in rhinology. However, the histopathological analysis of the hypertrophic IT is unclear. Therefore, this study aimed to identify the histological changes and the most functional areas of the IT to assist otolaryngologists with improving and modifying surgical techniques and minimizing potential complications.</p></div><div><h3>Methods</h3><p>This prospective, cross-sectional study was conducted to evaluate the contribution of hypertrophic IT to nasal obstruction. For the analysis, a total of 38 adult patients (IT hypertrophy group and non-IT hypertrophy [control] group) were enrolled, and 131 specimens were obtained during the surgical procedures (IT hypertrophy group, endoscopic submucosal turbinoplasty and septoplasty; non-IT hypertrophy group, septoplasty). Intraoperative samples were collected from four sites of the IT to determine the dimensions, composition, and possible pathological changes in each individual site. The samples were analyzed using light microscopy.</p></div><div><h3>Results</h3><p>A comparison of the four sites of the IT in the IT hypertrophy group showed that the posterior end had the highest normal epithelium percentage, and cilia count. This suggests that preserving the functional part of the IT during surgery is crucial. Furthermore, a comparison of both groups in terms of basement membrane thickness and vessel wall thickness (<em>p</em> = 0.005 and <em>p</em> = 0.03, respectively) showed significant differences.</p></div><div><h3>Conclusion</h3><p>Our findings can assist otolaryngologists select the most appropriate surgical procedures for IT hypertrophy. In addition, they advocate the importance of preserving the functional part of the IT during surgical intervention to achieve an efficiently working IT and avoid undesirable complications while improving the nasal airway passage.</p></div><div><h3>Level of evidence</h3><p>Level 3.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"90 6","pages":"Article 101486"},"PeriodicalIF":1.7000,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424001010/pdfft?md5=0a873fa2335c75cc2a954a393608e4f6&pid=1-s2.0-S1808869424001010-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brazilian Journal of Otorhinolaryngology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1808869424001010","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

Inferior turbinate (IT) hypertrophy-induced chronic nasal obstruction is one of the most common problems in rhinology. However, the histopathological analysis of the hypertrophic IT is unclear. Therefore, this study aimed to identify the histological changes and the most functional areas of the IT to assist otolaryngologists with improving and modifying surgical techniques and minimizing potential complications.

Methods

This prospective, cross-sectional study was conducted to evaluate the contribution of hypertrophic IT to nasal obstruction. For the analysis, a total of 38 adult patients (IT hypertrophy group and non-IT hypertrophy [control] group) were enrolled, and 131 specimens were obtained during the surgical procedures (IT hypertrophy group, endoscopic submucosal turbinoplasty and septoplasty; non-IT hypertrophy group, septoplasty). Intraoperative samples were collected from four sites of the IT to determine the dimensions, composition, and possible pathological changes in each individual site. The samples were analyzed using light microscopy.

Results

A comparison of the four sites of the IT in the IT hypertrophy group showed that the posterior end had the highest normal epithelium percentage, and cilia count. This suggests that preserving the functional part of the IT during surgery is crucial. Furthermore, a comparison of both groups in terms of basement membrane thickness and vessel wall thickness (p = 0.005 and p = 0.03, respectively) showed significant differences.

Conclusion

Our findings can assist otolaryngologists select the most appropriate surgical procedures for IT hypertrophy. In addition, they advocate the importance of preserving the functional part of the IT during surgical intervention to achieve an efficiently working IT and avoid undesirable complications while improving the nasal airway passage.

Level of evidence

Level 3.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

下鼻甲的前瞻性组织病理学分析：鼻甲手术应保留哪些功能部位？

目的下鼻甲肥大引起的慢性鼻塞是鼻科最常见的问题之一。然而，肥大鼻甲的组织病理学分析尚不清楚。因此，本研究旨在确定肥厚 IT 的组织病理学变化和功能最强的区域，以帮助耳鼻喉科医生改进和修改手术技术，最大限度地减少潜在并发症。为了进行分析，共招募了 38 名成年患者（IT 肥厚组和非 IT 肥厚[对照]组），并在手术过程中获取了 131 份样本（IT 肥厚组，内窥镜粘膜下鼻甲成形术和鼻中隔成形术；非 IT 肥厚组，鼻中隔成形术）。术中从 IT 的四个部位采集样本，以确定每个部位的尺寸、组成和可能的病理变化。结果对 IT 肥厚组 IT 的四个部位进行比较后发现，后端正常上皮细胞百分比和纤毛数量最高。这表明在手术中保留 IT 的功能部分至关重要。此外，两组在基底膜厚度和血管壁厚度（分别为 p = 0.005 和 p = 0.03）方面的比较也显示出显著差异。此外，我们还提倡在手术干预过程中保留 IT 功能部分的重要性，以实现 IT 的有效工作，避免不良并发症，同时改善鼻腔气道通道。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Brazilian Journal of Otorhinolaryngology OTORHINOLARYNGOLOGY-

CiteScore

3.00

自引率

0.00%

发文量

205

审稿时长

4-8 weeks

期刊介绍： Brazilian Journal of Otorhinolaryngology publishes original contributions in otolaryngology and the associated areas (cranio-maxillo-facial surgery and phoniatrics). The aim of this journal is the national and international divulgation of the scientific production interesting to the otolaryngology, as well as the discussion, in editorials, of subjects of scientific, academic and professional relevance. The Brazilian Journal of Otorhinolaryngology is born from the Revista Brasileira de Otorrinolaringologia, of which it is the English version, created and indexed by MEDLINE in 2005. It is the official scientific publication of the Brazilian Association of Otolaryngology and Cervicofacial Surgery. Its abbreviated title is Braz J Otorhinolaryngol., which should be used in bibliographies, footnotes and bibliographical references and strips.