0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters to the Editor |

Query, Concerning Mechanism of Inferior Turbinate Enlargement

Ronald Eccles, PhD
Arch Otolaryngol Head Neck Surg. 2007;133(6):624. doi:10.1001/archotol.133.6.624-a.
Text Size: A A A
Published online

Extract

In the June 2006 issue of the Archives, Berger et al1 discuss the histopathologic changes associated with hypertrophy of the inferior turbinate and compare the findings of histologic evaluation in 17 patients with refractory inferior turbinate hypertrophy with those in 12 subjects with normal inferior turbinates. This is an interesting area for research as there is little information on the topic in the literature apart from some articles by this research group. When I first read the abstract, I was concerned that there could be an ethical problem in removing the inferior turbinate from normal volunteers, but as I read the main text my concern was about the validity of the study. The authors claim that the turbinate tissue in the control group was normal, yet in the “Methods” section they describe the control group as patients with anatomically narrow nasal passages who underwent septoplasy and turbinectomy. I cannot see how a group of patients who have nasal obstruction severe enough to need nasal surgery with septoplasty and turbinectomy can be classified as having normal nasal turbinates. Changes in the anatomy of the nasal passages and changes in airflow are known to cause changes in the size and structure of the nasal turbinates, and this is the main thesis that the authors are pursuing, so it is to be expected that the control group cannot be a proper control for this type of study. I am unaware of any purely anatomical problem of the nasal passages apart from a nasal septal deviation that can cause nasal obstruction, and it would be useful if the authors could provide more information about this unusual group of patients. For example, was the anatomical problem an acquired condition due to trauma or was it related to some congenital problem with the development of the nasal passages? Presumably, this anatomical abnormality had been present for some time; otherwise, the patients would not have been referred to a surgeon for treatment. I have doubts about the validity of the study and especially about the comparisons between the 2 groups. If the subjects in the control group were “normal,” why were they undergoing nasal surgery? I also have reservations about the term turbinate hypertrophy, which is in common use, but I am sure that Berger and colleagues do not use it in its correct histologic sense of meaning enlarged cells. A better term for these conditions would be turbinate enlargement, which could be caused by vascular engorgement of venous sinuses, tissue hyperplasia, or tissue hypertrophy.

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

June 1, 2007
Gilead Berger, MD; Svetlana Gass, MSc; Dov Ophir, MD
Arch Otolaryngol Head Neck Surg. 2007;133(6):624-625. doi:10.1001/archotol.133.6.624-b.
CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Jobs
brightcove.createExperiences();