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At least 217 records · Page 12Linked to original sources
PubMed1990

Resection of obstructing inferior turbinates following rhinoplasty.

Total inferior turbinectomy was carried out in 38 patients who complained of nasal obstruction following rhinoplasty or rhinoseptoplasty and in whom hypertrophied inferior turbinates were found to be the cause of obstruction. Postoperatively, relief of nasal obstruction was reported by 84 percent of patients, while rhinoscopy showed wide, clean nasal airways in 92 percent. Nasal airflow measurements in 32 tested patients showed increased patency in all of them, including 3 who still complained of nasal obstruction postoperatively. The follow-up period ranged from 1 to 7 years (mean 2.8 years). Atrophic changes of the nasal mucosa or chronic purulent infection was not observed in any of the patients. Because the results of partial procedures on the inferior turbinates are often unsatisfactory, I suggest performing total inferior turbinectomy in patients with obstructing inferior turbinates following rhinoplasty.

Adolescent↗
PubMed1996

Long-term results of trimming of the inferior turbinates.

The long-term benefit of trimming of the inferior turbinates for nasal obstruction is unclear and our aim was to assess this. Fourteen patients who had had pre-operative nasal symptom scores and anterior rhinomanometry prior to inferior turbinate resection were reassessed at least 7 years post-operatively. Both nasal symptom scores for obstruction and nasal resistance had increased significantly in the intervening time period. Nasal crusting and hypertrophy of the cut inferior turbinate are considered to be responsible for this. Patients should be warned some degree of nasal obstruction may recur postoperatively.

Adult↗
PubMed1999

Partial resection of the middle turbinate at functional endoscopic sinus surgery.

The middle turbinate is often carefully preserved at Functional Endoscopic Sinus Surgery (FESS). However there is no clear understanding of its importance and its presence may prevent good access to the middle meatus to the detriment of the surgical result. In addition its bulk may cause symptoms of nasal obstruction and prevent paranasal sinus drainage. Adhesions and stenosis have been reported at the middle meatus following its preservation. We undertook a prospective study of 50 consecutive patients all of whom underwent resection of the anterior half of the middle turbinate at the time of Functional Endoscopic Sinus Surgery. The patients were asked to complete a symptom score sheet before and ten weeks after surgery. The parameters considered were nasal obstruction, nasal congestion, discharge, facial pain and headache. Non parametric analysis of the results indicated a significant improvement in all patient symptom scores and no postoperative complications were noted. We conclude that partial resection of the middle turbinate is a useful modification of accepted endoscopic sinus surgery techniques.

Acute Disease↗
PubMed1985

Submucosal diathermy of the inferior turbinate and the congested nose.

Surgical correction of the congested nose is frequently attempted. In the absence of a septal deformity, engorgement of the inferior turbinate is usually held to be the culprit, and various procedures have been advocated to counter this problem. Submucosal diathermy to the inferior turbinates is widely practised, but relatively little has been published about it. 204 patients who underwent submucosal diathermy of the inferior turbinates between 1977 and 1983 have been studied. 60 patients have been followed up by questionnaire, for periods ranging from 1 to 5 years since surgery. Surgery was of benefit in up to 72% of cases. Surgical technique and the problems of patient selection and assessment are discussed.

Adolescent↗
PubMed2003

Treatment of inferior turbinate hypertrophy: a randomized clinical trial.

In the past 130 years, many surgical procedures for turbinate reduction have been developed. We analyzed the long-term efficacy of 6 of these surgical techniques (turbinectomy, laser cautery, electrocautery, cryotherapy, submucosal resection, and submucosal resection with lateral displacement) over a 6-year follow-up period. We randomly divided 382 patients into 6 therapeutic groups and surgically treated them at the Department of Otorhinolaryngology of the University of Siena. After 6 years, only submucosal resection resulted in optimal long-term normalization of nasal patency and in restoration of mucociliary clearance and local secretory IgA production to a physiological level with few postoperative complications (p < .001). The addition of lateral displacement of the inferior turbinate improved the long-term results. We recommend, in spite of the greater surgical skill required, submucosal resection combined with lateral displacement as the first-choice technique for the treatment of nasal obstruction due to hypertrophy of the inferior turbinates.

Adolescent↗
PubMed1984

Production of mucous glycoproteins by nasal turbinates in vitro.

An in vitro system of human nasal turbinate tissue culture has been developed. Nasal turbinate tissue resected during surgery for nasal obstruction is dissected free of bone, placed on absorbable gelatin sponges, and cultured with CMRL-1066 medium containing antibiotics. Viability of explants may be demonstrated both physiologically and histologically through a period of 4 weeks. 3H-glucosamine added to the medium is biosynthetically incorporated into mucous glycoprotein (MGP). Gel filtration column chromatography on Sephacryl S-1000 in 6M urea in 0.005M phosphate buffer demonstrates human turbinate MGP to fractionate with 85% of the radiolabel filtered and 15% excluded by the column. The excluded MGP fractionates with globular proteins of greater than 20 X 10(6) daltons, while the fractions that enter the column filter with molecular sizes of 0.4 X 10(6) to 20 X 10(6) daltons. MGP synthesized by human lung airways has comparable sizing characteristics, suggesting a similarity in upper and lower airway mucus chemistry.

Culture Techniques↗
PubMed1984

Surgery of the inferior turbinates: how much and when?

Surgery of the inferior turbinates should be performed only after a trial period of medical therapy. Surgical reduction in turbinate size may be accomplished by outfracture crushing, cauterization, cryotherapy, laser vaporization, submucous resection, partial turbinate resection, turbinoplasty, or total turbinectomy. The procedure chosen should be the most conservative one consistent with obtaining a good airway.

Humans↗
PubMedDate not supplied

Unilateral exophthalmos associated with ipsilateral mucosal turbinate hypertrophy: benign exophthalmos syndrome (BES). A description of a new clinical condition.

PURPOSE: To report the clinical and radiologic characteristics of a group of patients who experienced unilateral exophthalmos associated with ipsilateral mucosal turbinate hypertrophy. The clinical features of these patients are presented and a hypothesis proposed to explain this condition for which the authors introduce the term benign exophthalmos syndrome (BES). METHODS: Retrospective, noncomparative case series. PARTICIPANTS: Four patients experienced slow progressive unilateral exophthalmos associated with ipsilateral mucosal turbinate hypertrophy, with no evidence of orbital mass or extraocular muscles involvement. INTERVENTION: Main Outcome Measures. Symptomatic outcome and measurement of the degree of relative exophthalmos. RESULTS: The onset of exophthalmos was associated with clinical and radiologic features that resemble BES. In all patients, radiologic examination demonstrated an ipsilateral mucosal turbinate hypertrophy and not the presence of orbital disease or expanding lesions of paranasal sinus. After daily intranasal spray of steroid, in three of the four cases the globe returned to within 1 mm of exophthalmometry of the contralateral eye. CONCLUSIONS: The relationship between the feature of paranasal sinus disease and the development of ipsilateral exophthalmos has been described in the literature. The four cases described herein appear peculiar for the slow progressive onset of the exophthalmos, without inflammatory and mass effect signs. This condition associated in all cases with ipsilateral hypertrophy of the nasal mucosa provides a guide to a hypothetical mechanism for BES. According to these hypothesis, the therapy should be devoted to the nasal disease more than the orbital.

Administration, Intranasal↗
PubMed1991

Turbinate hypertrophy in habitual snorers and patients with obstructive sleep apnea: findings of acoustic rhinometry.

Forty-five habitual snorers (mean respiratory disturbance index = 6) and 22 patients with obstructive sleep apnea syndrome (mean respiratory disturbance index = 36) were examined by polysomnography, radiocephalometry, rhinomanometry, nasopharyngeal videoendoscopy, and acoustic rhinometry. In 97% of these patients, hypertrophy of the inferior nasal turbinates was found by acoustic rhinometry, while increased nasal resistance of various degrees was measured in 93% of all patients by active anterior rhinomanometry. Acoustic rhinometry demonstrated that the most resistive segment was located in the anterior parts of the nasal cavity and was built up by two compartments: the region of the isthmus nasi and the region of the head of the inferior turbinate. In our snoring patients, the cross-sectional areas at the head of the inferior turbinate were always smaller than the cross-sectional areas in the isthmus nasi, which in normal controls presented the minimal cross-sectional values of the whole nasal cavity. While rhino-manometry can only measure the amount of nasal resistance, acoustic rhinometry can clearly determine the exact size and location of the different stenoses in the nasal cavity that contribute to the increased nasal resistance.

Acoustics↗
PubMed1995

Nd:YAG laser turbinate surgery animal experimental study: preliminary report.

The chronically hypertrophic nasal turbinate is a challenging problem for otolaryngologists. Although some success has been achieved with a number of medical and surgical methods, other forms of treatment are still needed. In this study, encouraging results were achieved using the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser on canine turbinates. Clinical and histological results showed that with Nd:YAG laser surgery, coagulation occurs in the deep cavernous vessels and submucosal glands of the turbinate, while the overlying mucosa remains intact.

Animals↗
PubMed1992

Toxigenic type A Pasteurella multocida as a causative agent of nasal turbinate atrophy in swine.

Although no clinical signs of atrophic rhinitis (AR) were recognized in 2- and 5-week-old pigs, approximately 60% of 2- to 6-month-old pigs showed clinical signs of AR in an affected pig farm. None of the pigs had normal turbinate at slaughter. Bordetella bronchiseptica was not isolated from any of the pigs before onset and incipient stage of the outbreak (2-week to 2-month-old). Pasteurella multocida of capsular type D was not isolated from any of those pigs. However, toxigenic P. multocida of capsular type A was isolated from a number of the pigs immediately before onset and incipient stage of the outbreak. Thirty-six-day-old primary specific-pathogen-free pigs were inoculated intranasally with a toxigenic type A P. multocida isolated from a 5-week-old pig. Severe nasal turbinate atrophy was observed in those pigs which were necropsied at 3 weeks post-inoculation. This is the first report on outbreak of severe nasal turbinate atrophy induced by toxigenic type A P. multocida in Japan.

Animals↗
PubMedDate not supplied

Middle turbinate graft for repair of cerebral spinal fluid leaks.

Endoscopic management of CSF leaks has been reported as highly successful by several authors. Various techniques are used for site preparation, graft selection, and graft stabilization. In this report the middle turbinate as a donor site for repair is described. Guidelines for harvest, preparation, and application are presented. The middle turbinate graft can be used as a free mucosal graft for linear cracks or small defects, as a composite bone/mucosal graft for moderate sized defects, or as a donor site for separate bone and mucosal grafts for large defects or encephaloceles when intracranial bone placement is desirable. Experience with 18 patients is presented with 100% initial graft take, and 17/18 (94%) with long term success. The middle turbinate is an excellent source of donor material for repair of almost any endoscopically repairable CSF leak.

Adult↗
PubMedDate not supplied

Inferior turbinate goblet cell secretion in patients with perennial allergic and nonallergic rhinitis.

Perennial rhinitis is clinically associated with a significant increase in nasal mucus secretion. Moreover, it has already been established that the number of goblet cells, in the inferior turbinates of patients with perennial allergic and nonallergic rhinitis, does not differ from that of normal subjects. Thus a question is raised, whether the above-mentioned phenomenon is ascribed exclusively to submucosal glandular activity, or may also be a result of a nonhyperplastic increase of goblet cell functional activity. This study was conducted to assess inferior turbinate goblet cell mucus secretion in a cohort of patients with perennial allergic and nonallergic rhinitis compared with normal controls. A semiquantitative morphometric method was used to examine goblet cell mucus secretion in sections stained with Alcian blue and periodic acid Schiff. Mucus secretion in each section was established in terms of secretory ratio, calculated as the number of secreting goblet cells divided by the number of nonsecreting ones. The mean secretory ratio of patients with perennial allergic (n = 11) and nonallergic rhinitis (n = 23) was 0.89 and 0.57, respectively, compared to controls (n = 10) 0.25. Statistical analysis confirmed that the secretory ratio of patients with perennial allergic rhinitis was significantly higher than that of the control group. No significant difference prevailed between patients with perennial nonallergic rhinitis and controls, as well as between allergic and nonallergic patients. Based on the results of the study, a basal state of nasal goblet cell mucus secretion in nonstimulated healthy people was established. Furthermore, it was concluded that the enhancement in mucus discharge, from the inferior turbinate goblet cells of patients with perennial allergic rhinitis, was attributed to a nonhyperplastic increase of nasal goblet cell functional activity.

Analysis of Variance↗
PubMedDate not supplied

Detection of rhinovirus in turbinate epithelial cells of chronic sinusitis.

BACKGROUND: In contrast to the well-established association of rhinovirus (RV) with acute sinusitis, little is known about the role of RV infections in the pathogenesis of chronic sinusitis. Therefore, we assayed the nasal cavity mucosae of chronic sinusitis patients lacking signs of acute viral infection for the presence of RV. METHODS: Nasal lavage fluids and turbinate epithelial cells from 39 sinusitis patients and 27 control subjects were tested. Turbinate epithelial cells were collected using a Rhino-probe mucosal curette. Picornavirus was assayed by an initial reverse-transcription polymerase chain reaction (PCR), and picornavirus-positive samples were assayed by nested reverse-transcription PCR to detect RV. RESULTS: All lavage fluids from both groups, as well as control epithelial cells, were negative for picornavirus. In contrast, 8 of 39 (21%) epithelial cell samples from sinusitis patients were positive for picornavirus. RV-specific nested-PCR revealed that all eight of these samples were positive for RV. CONCLUSION: The detection of RV in the turbinate epithelial cells of chronic sinusitis patients suggests that RV may be important in the pathogenesis of chronic sinusitis.

Adult↗
PubMed1996

[Distribution of neuropeptides in the inferior nasal turbinate mucosa of patients with allergic rhinitis].

An immunohistochemical study was made on the distribution of neuropeptides in 36 surgical specimens of the inferior nasal turbinate mucosa obtained from 32 patients with allergic rhinitis. Eleven patients (15 specimens) of the 32 underwent chemosurgery in which trichloracetic acid (TCA) was used before excision. In these patients a watery nasal discharge remained even after TCA application, although the nasal obstruction decreased. As a control, 6 specimens obtained from 6 patients with non-allergic rhinitis were also studied. In the present study, the distribution of Substance P (SP) was examined as an index of the parasympathetic nervous system. The distribution of nerve fibers showing a positive reaction specific to each of the two types of neuropeptides was examined in the frontal sections of the specimens at distances of 5 and 15 mm from the anterior tip of the inferior turbinate. In particular, the modes of the distribution in the superficial and deep layers of the mucosa were compared. It was found that, in the patients with allergic rhinitis who had not undergone TCA treatment, both SP-positive and VIP-positive fibers were abundant in the anterior portion of the turbinate immediately beneath the basement membrane. In those patients who underwent chemosurgery prior to excision, SP-positive fibers were very scarce in both superficial and deep layers, whereas VIP-positive fibers appeared to exist only in the deep layer around the remaining nasal glands. In the specimens obtained from patients with non-allergic rhinitis, there was no appreciable difference in the pattern of distribution of SP-and VIP-positive fibers among different sites of the specimens. The present study would indicate that chemosurgery using TCA inhibited the appearance of neuropeptides and resulted in improvement in clinical symptoms. However, in those patients having a continuous watery discharge even after TCA treatment, the function of the remaining nasal glands might be responsible for the symptom, although the contribution of VIP to the increase in vasopermeability should also be taken into consideration. Further studies are needed to determine the distribution of neuropeptides around the vessel walls.

Female↗
PubMed2000

Middle turbinate medialization technique in functional endoscopic sinus surgery.

The middle turbinate is an important surgical landmark in functional endoscopic sinus surgery (FESS). Postoperatively, lateralization may obstruct the middle meatus, thereby increasing the risk of complications and recurrences. A new medialization technique using metallic clips between the head of the middle turbinate and the septum is described. The aim of this study is to evaluate the clip medialization technique applied in 56 cases of bilateral FESS. We think that this simple technique, with its low rate of complications, is an adequate and simple procedure for middle turbinate medialization. A good and accessible middle meatus was observed in 54 patients.

Adult↗
PubMed1975

Electron microscopic evaluation of bone cells in pigs with experimentally induced Bordetella rhinitis (turbinate osteoporosis).

The development of osseous lesions in the nasal turbinates of pigs with experimentally induced Bordetella rhinitis, occurring 2 to 6 weeks after inoculation with Bordetella bronchiseptica strain B, was evaluated ultrastructurally, and comparisons were made with controls. Progressive degenerative changes were seen in osteoblasts and osteocytes of diseased pigs. These changes included swollen mitochondria, distention of cisternae of endoplasmic reticulum, and lysis of some cells. Bacterial organisms, believed to be B bronchiseptica, were observed in the cytoplasm of osteoblasts and inclose proximity to bone surfaces in diseased pigs. Although osteoclasts occasionally had degenerative changes in the brush border, most osteoclasts wer similar to those of control pigs. Resorption of bone adjacent to degenerative osteoblasts and osteocytes may have contributed to the development of turbinate osteoporosis when combined with the normal cellular resorptive processes. Thes ultrastructural changes were similar to those previously reported in bone cells of the nasal turbinates of pigs with experimentally induced and naturally occurring atrophic rhinitis.

Animals↗
PubMed2000

Treatment of inferior turbinate pathology: a review and critical evaluation of the different techniques.

At least 13 surgical techniques have been used over the past 130 years to treat hypertrophy of the inferior turbinate. These methods are reviewed and critically analyzed in this article. Our review of the literature revealed a serious lack of qualified studies. Research meeting the criteria for a prospective comparative randomized surgical study is extremely rare. In our opinion, the purpose of surgically reducing the inferior turbinates should be to diminish complaints while preserving function. From that perspective, it seems that electrocautery, chemocautery, (subtotal) turbinectomy, cryosurgery, and laser surface surgery should not be used, as these techniques are too destructive. Intratubinal turbinate reduction (intraturbinal turbinoplasty) would seem to be the method of choice.

Electrocoagulation↗