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J Cosmet Med 2022; 6(2): 72-77

Published online December 31, 2022

https://doi.org/10.25056/JCM.2022.6.2.72

Morphological analysis of the inferior turbinate with septal deviations in the Korean population using computed tomography

Yeong Joon Kim, MD1 , Chang Hoi Kim, MD2 , Jooyeon Kim, MD, PhD1 , Gilsoon Choi, MD, PhD3 , Yeong Wook Jeong, MD1 , Jaehwan Kwon, MD, PhD1

1Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Rep. of Korea, 2Department of Otolaryngology-Head and Neck Surgery, Dongguk University Gyeongju Hospital, Gyeongju, Rep. of Korea, 3Department of Internal Medicine, Kosin University College of Medicine, Busan, Rep. of Korea

Correspondence to :
Jaehwan Kwon
E-mail: entkwon@hanmail.net

Received: August 17, 2022; Revised: November 17, 2022; Accepted: November 17, 2022

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Data on structural modifications caused by septal deviation may help otolaryngologists make informed decisions on the inclusion of turbinate surgery with septoplasty as well as identify the part of the inferior turbinate that requires more attention during surgery.
Objective: This study aimed to compare the dimensions of the ipsilateral and contralateral sides of the inferior turbinate and the septal deviation in a Korean population.
Methods: We retrospectively analyzed the facial computed tomography (CT) scans of 111 patients who underwent septoplasty between January 2012 and December 2017 for the anterior, posterior, and maximally deviated sites of the inferior turbinate.
Results: Statistical analyses revealed differences in the medial mucosa and the total thickness of the anterior and maximally deviated sites between the ipsilateral and contralateral sides. The medial mucosal portion of the anterior site was 4.64±2.12 mm on the contralateral side and 4.14±1.75 mm on the ipsilateral side (p=0.03). The total thickness of the anterior site was 9.72±4.25 mm on the contralateral side and 8.58±3.36 mm on the ipsilateral side (p=0.02). The medial mucosal portion of the maximally deviated site was 5.09±2.52 mm on the contralateral side and 4.39±2.05 mm on the ipsilateral side (p=0.04). The total thickness of the maximally deviated site was 9.58±4.06 mm on the contralateral side and 8.81±3.50 mm on the ipsilateral side (p=0.04). No significant differences were found in the measurements between the two sides of the posterior site or in the bone thickness at any of the sites. The inferior turbinate did not show any significant relationship with the deviation angle.
Conclusion: A conservative submucosal turbinoplasty without bone removal may be favorable.
Level of Evidence: Level IV

Keywords: nasal cavity, nasal septum, turbinates

Fig. 1.Measurement of the inferior turbinate at different sites. (A) The thicknesses of the lateral mucosa (a), bony portion (b), and medial mucosa (c) of the inferior turbinate were measured. (B) The anterior site of the inferior turbinate was measured at the level of the second cut of the middle turbinate using coronal computed tomography. (C) Measurement of the inferior turbinates at the maximally deviated site showed bone thickness at the maximally deviated site. (D) The posterior site of the inferior turbinate was measured immediately before the end of the bony portion of the inferior turbinate.
  1. Berger G, Hammel I, Berger R, Avraham S, Ophir D. Histopathology of the inferior turbinate with compensatory hypertrophy in patients with deviated nasal septum. Laryngoscope 2000;110:2100-5.
    Pubmed CrossRef
  2. Sam A, Deshmukh PT, Patil C, Jain S, Patil R. Nasal septal deviation and external nasal deformity: a correlative study of 100 cases. Indian J Otolaryngol Head Neck Surg 2012;64:312-8.
    Pubmed KoreaMed CrossRef
  3. Prasad S, Varshney S, Bist SS, Mishra S, Kabdwal N. Correlation study between nasal septal deviation and rhinosinusitis. Indian J Otolaryngol Head Neck Surg 2013;65:363-6.
    Pubmed KoreaMed CrossRef
  4. Serifoglu I, Oz İİ, Damar M, Buyukuysal MC, Tosun A, Tokgöz Ö. Relationship between the degree and direction of nasal septum deviation and nasal bone morphology. Head Face Med 2017;13:3.
    Pubmed KoreaMed CrossRef
  5. Egeli E, Demirci L, Yazýcý B, Harputluoglu U. Evaluation of the inferior turbinate in patients with deviated nasal septum by using computed tomography. Laryngoscope 2004;114:113-7.
    Pubmed CrossRef
  6. Grymer LF, Illum P, Hilberg O. Septoplasty and compensatory inferior turbinate hypertrophy: a randomized study evaluated by acoustic rhinometry. J Laryngol Otol 1993;107:413-7.
    Pubmed CrossRef
  7. Orhan I, Aydın S, Ormeci T, Yılmaz F. A radiological analysis of inferior turbinate in patients with deviated nasal septum by using computed tomography. Am J Rhinol Allergy 2014;28:e68-72.
    Pubmed CrossRef
  8. Hilberg O, Grymer LF, Pedersen OF, Elbrønd O. Turbinate hypertrophy. Evaluation of the nasal cavity by acoustic rhinometry. Arch Otolaryngol Head Neck Surg 1990;116:283-9.
    Pubmed CrossRef
  9. Passàli D, Passàli FM, Damiani V, Passàli GC, Bellussi L. Treatment of inferior turbinate hypertrophy: a randomized clinical trial. Ann Otol Rhinol Laryngol 2003;112:683-8.
    Pubmed CrossRef
  10. Patel B, Virk JS, Randhawa PS, Andrews PJ. The internal nasal valve: a validated grading system and operative guide. Eur Arch Otorhinolaryngol 2018;275:2739-44.
    Pubmed KoreaMed CrossRef
  11. Wexler DB, Davidson TM. The nasal valve: a review of the anatomy, imaging, and physiology. Am J Rhinol 2004;18:143-50.
    CrossRef
  12. Shaida AM, Kenyon GS. The nasal valves: changes in anatomy and physiology in normal subjects. Rhinology 2000;38:7-12.

Article

Original Article

J Cosmet Med 2022; 6(2): 72-77

Published online December 31, 2022 https://doi.org/10.25056/JCM.2022.6.2.72

Copyright © Korean Society of Korean Cosmetic Surgery.

Morphological analysis of the inferior turbinate with septal deviations in the Korean population using computed tomography

Yeong Joon Kim, MD1 , Chang Hoi Kim, MD2 , Jooyeon Kim, MD, PhD1 , Gilsoon Choi, MD, PhD3 , Yeong Wook Jeong, MD1 , Jaehwan Kwon, MD, PhD1

1Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Rep. of Korea, 2Department of Otolaryngology-Head and Neck Surgery, Dongguk University Gyeongju Hospital, Gyeongju, Rep. of Korea, 3Department of Internal Medicine, Kosin University College of Medicine, Busan, Rep. of Korea

Correspondence to:Jaehwan Kwon
E-mail: entkwon@hanmail.net

Received: August 17, 2022; Revised: November 17, 2022; Accepted: November 17, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Data on structural modifications caused by septal deviation may help otolaryngologists make informed decisions on the inclusion of turbinate surgery with septoplasty as well as identify the part of the inferior turbinate that requires more attention during surgery.
Objective: This study aimed to compare the dimensions of the ipsilateral and contralateral sides of the inferior turbinate and the septal deviation in a Korean population.
Methods: We retrospectively analyzed the facial computed tomography (CT) scans of 111 patients who underwent septoplasty between January 2012 and December 2017 for the anterior, posterior, and maximally deviated sites of the inferior turbinate.
Results: Statistical analyses revealed differences in the medial mucosa and the total thickness of the anterior and maximally deviated sites between the ipsilateral and contralateral sides. The medial mucosal portion of the anterior site was 4.64±2.12 mm on the contralateral side and 4.14±1.75 mm on the ipsilateral side (p=0.03). The total thickness of the anterior site was 9.72±4.25 mm on the contralateral side and 8.58±3.36 mm on the ipsilateral side (p=0.02). The medial mucosal portion of the maximally deviated site was 5.09±2.52 mm on the contralateral side and 4.39±2.05 mm on the ipsilateral side (p=0.04). The total thickness of the maximally deviated site was 9.58±4.06 mm on the contralateral side and 8.81±3.50 mm on the ipsilateral side (p=0.04). No significant differences were found in the measurements between the two sides of the posterior site or in the bone thickness at any of the sites. The inferior turbinate did not show any significant relationship with the deviation angle.
Conclusion: A conservative submucosal turbinoplasty without bone removal may be favorable.
Level of Evidence: Level IV

Keywords: nasal cavity, nasal septum, turbinates

Fig 1.

Figure 1.Measurement of the inferior turbinate at different sites. (A) The thicknesses of the lateral mucosa (a), bony portion (b), and medial mucosa (c) of the inferior turbinate were measured. (B) The anterior site of the inferior turbinate was measured at the level of the second cut of the middle turbinate using coronal computed tomography. (C) Measurement of the inferior turbinates at the maximally deviated site showed bone thickness at the maximally deviated site. (D) The posterior site of the inferior turbinate was measured immediately before the end of the bony portion of the inferior turbinate.
Journal of Cosmetic Medicine 2022; 6: 72-77https://doi.org/10.25056/JCM.2022.6.2.72

References

  1. Berger G, Hammel I, Berger R, Avraham S, Ophir D. Histopathology of the inferior turbinate with compensatory hypertrophy in patients with deviated nasal septum. Laryngoscope 2000;110:2100-5.
    Pubmed CrossRef
  2. Sam A, Deshmukh PT, Patil C, Jain S, Patil R. Nasal septal deviation and external nasal deformity: a correlative study of 100 cases. Indian J Otolaryngol Head Neck Surg 2012;64:312-8.
    Pubmed KoreaMed CrossRef
  3. Prasad S, Varshney S, Bist SS, Mishra S, Kabdwal N. Correlation study between nasal septal deviation and rhinosinusitis. Indian J Otolaryngol Head Neck Surg 2013;65:363-6.
    Pubmed KoreaMed CrossRef
  4. Serifoglu I, Oz İİ, Damar M, Buyukuysal MC, Tosun A, Tokgöz Ö. Relationship between the degree and direction of nasal septum deviation and nasal bone morphology. Head Face Med 2017;13:3.
    Pubmed KoreaMed CrossRef
  5. Egeli E, Demirci L, Yazýcý B, Harputluoglu U. Evaluation of the inferior turbinate in patients with deviated nasal septum by using computed tomography. Laryngoscope 2004;114:113-7.
    Pubmed CrossRef
  6. Grymer LF, Illum P, Hilberg O. Septoplasty and compensatory inferior turbinate hypertrophy: a randomized study evaluated by acoustic rhinometry. J Laryngol Otol 1993;107:413-7.
    Pubmed CrossRef
  7. Orhan I, Aydın S, Ormeci T, Yılmaz F. A radiological analysis of inferior turbinate in patients with deviated nasal septum by using computed tomography. Am J Rhinol Allergy 2014;28:e68-72.
    Pubmed CrossRef
  8. Hilberg O, Grymer LF, Pedersen OF, Elbrønd O. Turbinate hypertrophy. Evaluation of the nasal cavity by acoustic rhinometry. Arch Otolaryngol Head Neck Surg 1990;116:283-9.
    Pubmed CrossRef
  9. Passàli D, Passàli FM, Damiani V, Passàli GC, Bellussi L. Treatment of inferior turbinate hypertrophy: a randomized clinical trial. Ann Otol Rhinol Laryngol 2003;112:683-8.
    Pubmed CrossRef
  10. Patel B, Virk JS, Randhawa PS, Andrews PJ. The internal nasal valve: a validated grading system and operative guide. Eur Arch Otorhinolaryngol 2018;275:2739-44.
    Pubmed KoreaMed CrossRef
  11. Wexler DB, Davidson TM. The nasal valve: a review of the anatomy, imaging, and physiology. Am J Rhinol 2004;18:143-50.
    CrossRef
  12. Shaida AM, Kenyon GS. The nasal valves: changes in anatomy and physiology in normal subjects. Rhinology 2000;38:7-12.

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