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 Nasal Cavity Anatomy, Physiology, and Anomalies on CT Scan.

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 Medscape Reference article Nasal Physiology.

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.

Treatment & Management

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. 2012 Jan. 68(1):46-8. [QxMD MEDLINE Link].
Clark DW, Del Signore AG, Raithatha R, Senior BA. Nasal airway obstruction: prevalence and anatomic contributors. Ear Nose Throat J. 2018 Jun. 97 (6):173-6. [QxMD MEDLINE Link].
Salzano FA, Mora R, Penco S, Traverso D, Gaggero G, Salzano G, et al. Nasal tactile sensitivity in allergic rhinitis. Acta Otolaryngol. 2011 Jun. 131(6):640-4. [QxMD MEDLINE Link].
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. 2006 Mar-Apr. 20(2):238-40. [QxMD MEDLINE Link].
Sharhan SSA, Lee EJ, Hwang CS, et al. Radiological comparison of inferior turbinate hypertrophy between allergic and non-allergic rhinitis: does allergy really augment turbinate hypertrophy?. Eur Arch Otorhinolaryngol. 2018 Apr. 275 (4):923-9. [QxMD MEDLINE Link].
Freeman SC, Kahwaji CI. Physiology, Nasal. StatPearls. 2018 Jan. [QxMD MEDLINE Link]. [Full Text].
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. 2006 Sep-Oct. 27(5):314-8. [QxMD MEDLINE Link].
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. 2012 Jan. 146(1):146-50. [QxMD MEDLINE Link].
Liu CM, Tan CD, Lee FP, Lin KN, Huang HM. Microdebrider-assisted versus radiofrequency-assisted inferior turbinoplasty. Laryngoscope. 2009 Feb. 119(2):414-8. [QxMD MEDLINE Link].
Barham HP, Thornton MA, Knisely A, Marcells GN, Harvey RJ, Sacks R. Long-term outcomes in medial flap inferior turbinoplasty are superior to submucosal electrocautery and submucosal powered turbinate reduction. Int Forum Allergy Rhinol. 2016 Feb. 6 (2):143-7. [QxMD MEDLINE Link].
Whelan RL, Shaffer AD, Stapleton AL. Efficacy of inferior turbinate reduction in pediatric patients: a prospective analysis. Int Forum Allergy Rhinol. 2021 Jun 16. [QxMD MEDLINE Link].
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Media Gallery

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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Author

Sanford M Archer, MD, FACS Professor of Surgery and Pediatrics, Medical Director, UK Voice and Swallowing Clinic, Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Chandler Medical Center

Sanford M Archer, MD, FACS 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, Kentucky Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

Dominique Dorion, MD, MSc, FRCSC, FACS Dean, Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Université de Sherbrooke, Canada

Dominique Dorion, MD, MSc, FRCSC, FACS is a member of the following medical societies: Canadian Society of Otolaryngology-Head & Neck Surgery

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Emeritus 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, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan; Neosoma; MI10;<br/>Received income in an amount equal to or greater than $250 from: Neosoma; Cyberionix (CYBX)<br/>Received ownership interest from Cerescan for consulting for: Neosoma, MI10 advisor.

Acknowledgements

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.

Acknowledgments

Medscape Drugs and Diseases 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.

Turbinate Dysfunction Workup

Imaging Studies

Other Tests

Histologic Findings

References

Tables

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