Turbinate Reduction Rhinoplasty Workup

Updated: Oct 31, 2018
  • Author: Elizabeth Whitaker, MD, FACS; Chief Editor: Mark S Granick, MD, FACS  more...
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Workup

Imaging Studies

CT

CT is not indicated in the workup of inferior turbinate hypertrophy alone. However, if a CT scan of the head, facial bones, or sinuses has been obtained for other reasons, it may provide useful information. Axial and particularly coronal images can help assess the amount of bony versus mucosal hypertrophy.

If clinical presentation raises the concern of other obstructive processes such as nasal polyps or masses, perform CT imaging of the nose and sinuses.

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Other Tests

Rhinomanometry

Rhinomanometry is a technique for measuring nasal airway resistance. It is limited in that it does not provide a diagnosis or etiology of the obstruction. It provides a measure of nasal resistance at a specific time.

Perform the technique by applying a tight-fitting mask with a central aperture connected to a low-resistance pneumotachograph flow meter. Measure transnasal pressure at the nostril with a catheter with a pressure-tight seal. A second catheter measures air pressure in the mask. The catheters are attached to a differential pressure transducer and the outputs are recorded as a pressure flow diagram.

This technology has been used in a variety of studies to document changes in nasal resistance with nasal surgery. It has also been used to try and differentiate mucosal from bony hypertrophy with variable results. The use of this technique in routine clinical practice has not been demonstrated.

Allergy testing

The microscopic analysis of nasal mucus for eosinophils can be useful in making the diagnosis of allergic rhinitis.

Patients with allergic rhinitis that is not responsive to medications such as topical corticosteroids and antihistamines may benefit from allergy testing and possible immunotherapy.

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Diagnostic Procedures

Rigid nasal endoscopy

When indicated by clinical presentation, more extensive examination of the nose can be performed with a rigid or flexible endoscope. This examination allows additional assessment of the septum posteriorly, the nasopharynx, and the sinus ostia. Nasal masses or polyps as a cause of obstruction can be evaluated.

Purulent drainage may indicate sinusitis. Evidence of a septal perforation may indicate prior surgery, cocaine or topical decongestant abuse, or an inflammatory disease. Significant crusting or abnormality of the mucosal appearance may indicate a systemic disorder.

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