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European Archives of Oto-Rhino-Laryngology

Published in:

01-06-2018 | Rhinology

Do turbinate reduction procedures restore epithelial integrity in patients with turbinate hypertrophy secondary to allergic rhinitis? A histopathological study

Authors: Vijaya Kumar Lukka, Tripti Meriel Jacob, Visalakshi Jeyaseelan, Vedantam Rupa

Published in: European Archives of Oto-Rhino-Laryngology | Issue 6/2018

Abstract

Purpose

Consensus has not been reached regarding the optimal reduction procedure for inferior turbinate hypertrophy in allergic rhinitis and whether such procedures result in improvement in mucosal architecture.

Methods

Twenty-nine patients aged 18–45 years (mean 26.8 years), with allergic rhinitis and inferior turbinate hypertrophy not responsive to medical therapy who underwent endoscopic submucosal diathermy (ESMD) (14 patients) or endoscopic submucosal resection (ESMR) (15 patients) with intraoperative and 3–6 months postoperative inferior turbinate biopsies, were included in the study. Epithelial and mucosal architecture was compared between the two groups.

Results

Both groups showed a significant decrease in epithelial denudation (p < 0.001), reversal of basement membrane thickening (p < 0.001) and increase in density of cilia (p < 0.001). The degree of improvement in histological characteristics between ESMD and ESMR groups was not significant.

Conclusions

Surgical intervention for inferior turbinate hypertrophy by both ESMD and ESMR results in significant restoration of nasal mucosal epithelium in patients with allergic rhinitis as early as 3-month postoperatively. There was, however, no significant difference in the histological changes between those who underwent ESMD and ESMR.

Clinical Trials of India, Registry Number

CTRI/2015/01/005373.

Available only for authorised users

Bhandarkar ND, Smith TL (2010) Outcomes of surgery for inferior turbinate hypertrophy. Curr Opin Otolaryngol Head Neck Surg 18(1):49–53. https://doi.org/10.1097/MOO.0b013e328334d974 CrossRefPubMed

Berger G, Gass S, Ophir D (2006) The histopathology of the hypertrophic inferior turbinate. Arch Otolaryngol Head Neck Surg 132(6):588–594. https://doi.org/10.1001/archotol.132.6.588 CrossRefPubMed

Berger G, Hammel I, Berger R, Avraham S, Ophir D (2000) Histopathology of the inferior turbinate with compensatory hypertrophy in patients with deviated nasal septum. Laryngoscope 110(12):2100–2105. https://doi.org/10.1097/00005537-200012000-00024 CrossRefPubMed

Hegazy M, Mohamed A, El-Hennawy A, El-Fouly M (2014) Histopathological study of hypertrophic inferior turbinate. Egypt J Otolaryngol 30(1):23–29. https://doi.org/10.4103/1012-5574.127189 CrossRef

Gindros G, Kantas I, Balatsouras DG, Kandiloros D, Manthos AK, Kaidoglou A (2009) Mucosal changes in chronic hypertrophic rhinitis after surgical turbinate reduction. Eur Arch Otorhinolaryngol 266(9):1409–1416. https://doi.org/10.1007/s00405-009-0916-9 CrossRefPubMed

Berger G, Ophir D, Pitaro K, Landsberg R (2008) Histopathological changes after coblation inferior turbinate reduction. Arch Otolaryngol Head Neck Surg 134(8):819–823. https://doi.org/10.1001/archotol.134.8.819 CrossRefPubMed

Neri G, Cazzato F, Mastronardi V, Pugliese M, Centurione MA, Di Pietro R, Centurione L (2016) Ultrastructural regenerating features of nasal mucosa following microdebrider-assisted turbinoplasty are related to clinical recovery. J Transl Med 14(1):164. https://doi.org/10.1186/s12967-016-0931-8 CrossRefPubMedPubMedCentral

Berger G, Bernheim J, Ophir D (2007) Epithelial shedding of the inferior turbinate in perennial allergic and nonallergic rhinitis: a riddle to solve. Arch Otolaryngol Head Neck Surg 133(1):78–82. https://doi.org/10.1001/archotol.133.1.78 CrossRefPubMed

Lukka VK, Kurien R, Varghese L, Rupa V (in press) Endoscopic submucosal resection versus endoscopic submucosal diathermy for inferior turbinate hypertrophy. Indian J Otolaryngol Head Neck Surg. https://doi.org/10.1007/s12070-018-1280-0IJOO-D-1700413.0

10.

. Gertner R, Podoshin L, Fradis M (1984) A simple method of measuring the nasal airway in clinical work. J Laryngol Otol 98(4):351–355CrossRefPubMed

11.

Watanabe K, Kiuna C (1998) Epithelial damage of nasal mucosa in nasal allergy. Ann Otol Rhinol Laryngol 107(7):564–570. https://doi.org/10.1177/000348949810700704 CrossRefPubMed

12.

Ordonez C, Ferrando R, Hyde DM, Wong HH, Fahy JV (2000) Epithelial desquamation in asthma: artifact or pathology? Am J Respir Crit Care Med 162(6):2324–2329. https://doi.org/10.1164/ajrccm.162.6.2001041 CrossRefPubMed

13.

Bachert C, Pawankar R, Zhang L, Bunnag C, Fokkens WJ, Hamilos DL, Jirapongsananuruk O, Kern R, Meltzer EO, Mullol J, Naclerio R, Pilan R, Rhee CS, Suzaki H, Voegels R, Blaiss M (2014) ICON: chronic rhinosinusitis. World Allergy Org J 7(1):25. https://doi.org/10.1186/1939-4551-7-25 CrossRef

14.

Constantino Gde T, Mello JF Jr (2009) Remodeling of the lower and upper airways. Braz J Otorhinolaryngol 75(1):151–156CrossRefPubMed

15.

Van Bruaene N, Bachert C (2011) Tissue remodeling in chronic rhinosinusitis. Curr Opin Allergy Clin Immunol 11(1):8–11. https://doi.org/10.1097/ACI.0b013e32834233ef CrossRefPubMed

16.

Bergeron C, Hamid Q (2005) Relationship between asthma and rhinitis: epidemiologic, pathophysiologic, and therapeutic aspects. Allergy Asthma Clin Immunol 1(2):81–87. https://doi.org/10.1186/1710-1492-1-2-81 PubMedPubMedCentralCrossRef

17.

Alho OP, Karttunen R, Karttunen TJ (2004) Nasal mucosa in natural colds: effects of allergic rhinitis and susceptibility to recurrent sinusitis. Clin Exp Immunol 137(2):366–372. https://doi.org/10.1111/j.1365-2249.2004.02530.x CrossRefPubMedPubMedCentral

18.

Cohen NA (2006) Sinonasal mucociliary clearance in health and disease. Ann Otol Rhinol Laryngol Suppl 196:20–26CrossRefPubMed

19.

Schmidt J, Zalewski P, Olszewski J, Olszewska-Ziaber A (2001) Histopathological verification of clinical indications to partial inferior turbinectomy. Rhinology 39(3):147–150PubMed

20.

Joniau S, Wong I, Rajapaksa S, Carney SA, Wormald PJ (2006) Long-term comparison between submucosal cauterization and powered reduction of the inferior turbinates. Laryngoscope 116(9):1612–1616. https://doi.org/10.1097/01.mlg.0000227999.76713.d3 CrossRefPubMed

21.

Passali D, Passali FM, Damiani V, Passali GC, Bellussi L (2003) Treatment of inferior turbinate hypertrophy: a randomized clinical trial. Ann Otol Rhinol Laryngol 112 (8):683–688. https://doi.org/10.1177/000348940311200806 CrossRefPubMed

22.

Chen YL, Tan CT, Huang HM (2008) Long-term efficacy of microdebrider-assisted inferior turbinoplasty with lateralization for hypertrophic inferior turbinates in patients with perennial allergic rhinitis. Laryngoscope 118(7):1270–1274. https://doi.org/10.1097/MLG.0b013e31816d728e CrossRefPubMed

Title: Do turbinate reduction procedures restore epithelial integrity in patients with turbinate hypertrophy secondary to allergic rhinitis? A histopathological study
Authors: Vijaya Kumar Lukka
Tripti Meriel Jacob
Visalakshi Jeyaseelan
Vedantam Rupa
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 6/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-018-4955-y

At a glance: The STEP trials

Springer Medicine

Do turbinate reduction procedures restore epithelial integrity in patients with turbinate hypertrophy secondary to allergic rhinitis? A histopathological study

Abstract

Purpose

Methods

Results

Conclusions

Clinical Trials of India, Registry Number

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Clinical Trials of India, Registry Number

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