Turbinate Dysfunction Workup

  • Author: Sanford M Archer, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Mar 5, 2012
 

Imaging Studies

Sinus CT scanning is useful for delineating the extent of disease in patients who have underlying chronic rhinosinusitis or acute recurrent rhinosinusitis. Anatomic relationships between the middle turbinate, the septum, and lateral nasal wall may also be useful in the evaluation of nasal headaches. Preferred scans are those in a coronal plane with 2- to 3-mm thickness and bony windows. Contrast is not helpful. See CT Scan, Nasal Cavity.

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Other Tests

Rhinomanometric testing is useful as a research tool to evaluate certain parameters of nasal airflow. Rhinomanometry is most useful for comparing nasal airflow from side to side and also in the preoperative evaluation of nasal airflow as compared with the postoperative situation. See the eMedicine article Nasal Physiology.

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Histologic Findings

Eosinophilic infiltration of the mucosal membranes leads to suspicion of allergic causes for turbinate inflammation. Infiltration by other inflammatory cells is also observed but is less diagnostic.

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Contributor Information and Disclosures
Author

Sanford M Archer, MD  Professor, Department of Surgery and Pediatrics, Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center

Sanford M Archer, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Head and Neck Society, American Rhinologic Society, American Society for Head and Neck Surgery, and Kentucky Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Gregory Branham, MD  Vice-Chair, Director, Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, St Louis University School of Medicine

Gregory Branham, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, and Missouri State Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Dominique Dorion, MD, MSc, FRCSC, FACS  Vice Dean and Associate Dean of Resources, Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Sherbrooke Faculty of Medicine, Canada

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Medvoy Ownership interest Management position; Cerescan Imaging Consulting; Headwatersmb Consulting fee Consulting; Venturequest Royalty Consulting

Additional Contributors

Medscape Reference thanks Vijay R Ramakrishnan, MD, Assistant Professor, Department of Otolaryngology, University of Colorado School of Medicine, for assistance with the video contribution to this article.

References

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  2. Wolstenholme CR, Philpott CM, Oloto EJ, Murty GE. Does the use of the combined oral contraceptive pill cause changes in the nasal physiology in young women?. Am J Rhinol. Mar-Apr 2006;20(2):238-40. [Medline].

  3. Ozcan C, Vayisoglu Y, Dogu O, Görür K. The effect of intranasal injection of botulinum toxin A on the symptoms of vasomotor rhinitis. Am J Otolaryngol. Sep-Oct 2006;27(5):314-8. [Medline].

  4. Singh DP, Forte AJ, Apostolides JG, Zahiri HR, Stromberg J, Alonso N, et al. Transoral submucosal resection of the inferior turbinate: a novel approach to functional rhinoplasty. Ann Plast Surg. Jan 2012;68(1):46-8. [Medline].

  5. Garzaro M, Pezzoli M, Landolfo V, Defilippi S, Giordano C, Pecorari G. Radiofrequency inferior turbinate reduction: long-term olfactory and functional outcomes. Otolaryngol Head Neck Surg. Jan 2012;146(1):146-50. [Medline].

  6. Liu CM, Tan CD, Lee FP, Lin KN, Huang HM. Microdebrider-assisted versus radiofrequency-assisted inferior turbinoplasty. Laryngoscope. Feb 2009;119(2):414-8. [Medline].

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  12. Grymer LF, Illum P, Hilberg O. Bilateral inferior turbinoplasty in chronic nasal obstruction. Rhinology. Mar 1996;34(1):50-3. [Medline].

  13. Hoover S. The nasal patho-physiology of headaches and migraines. Diagnosis and treatment of the allergy, infection and nasal septal spurs that cause them. Rhinol Suppl. 1987;2:1-23. [Medline].

  14. Kimmelman CP, Ali GH. Vasomotor rhinitis. Otolaryngol Clin North Am. Feb 1986;19(1):65-71. [Medline].

  15. Mabry RL. Intranasal steroids in rhinology: the changing role of intraturbinal injection. Ear Nose Throat J. Apr 1994;73(4):242-6. [Medline].

  16. Mabry RL. Rhinitis medicamentosa: the forgotten factor in nasal obstruction. South Med J. Jul 1982;75(7):817-9. [Medline].

  17. Mabry RL. Rhinitis of pregnancy. South Med J. Aug 1986;79(8):965-71. [Medline].

  18. Mabry RL. Surgery of the inferior turbinates: how much and when?. Otolaryngol Head Neck Surg. Oct 1984;92(5):571-6. [Medline].

  19. Morgenstein KM, Krieger MK. Experiences in middle turbinectomy. Laryngoscope. Oct 1980;90(10 Pt 1):1596-603. [Medline].

  20. Quine SM, Aitken PM, Eccles R. Effect of submucosal diathermy to the inferior turbinates on unilateral and total nasal airflow in patients with rhinitis. Acta Otolaryngol. 1999;119(8):911-5. [Medline].

  21. Scoppa J. Vasomotor rhinitis. A review and management by intranasal cryotherapy. Med J Aust. Nov 11 1985;143(10):448-50. [Medline].

 
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Normal-sized right inferior turbinate with a moderate inferior septal deflection.
Bony hypertrophy of the right inferior turbinate following topical vasoconstriction.
Mucosal hypertrophy of the right inferior turbinate with total airway obstruction.
Mucosal hypertrophy of the left inferior turbinate with impingement of the septum and narrowed nasal airway.
A stab incision is made at the anterior head of the inferior turbinate. Blunt dissection beneath the mucoperiosteum elevates tissue for subsequent microdebridement. The microdebrider is turned in all directions, but mucosa is entirely preserved. Video courtesy of Vijay R Ramakrishnan, MD.
 
 
 
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