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Letters to the Editor |

Query, Concerning Mechanism of Inferior Turbinate Enlargement—Reply

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.
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We thank Dr Eccles for his interest in our article on the histopathology of the hypertrophic inferior turbinate (IT).1 Dr Eccles' criticism mainly concerned our decision to use as normal controls ITs removed from patients who had nasal obstruction and relatively narrow nasal passages and who had undergone both septoplasty and IT reduction surgery. It is well known that for ethical reasons IT samples from healthy volunteers are unavailable. Samples from cadavers are also unattainable. Although all the control patients complained of nasal obstruction, none had a history of nasal allergy or had nasal discharge, postnasal drip, a sensation of itching, or sneezing. Apart from having a deviated nasal septum, preoperative anterior rhinoscopy and flexible endoscopy showed that their relatively narrow nasal passages had no effect on the ITs, which appeared normal in size and without apparent hypertrophy. The logic behind the decision to excise these ITs was to facilitate postoperative nasal breathing. Indeed, the results of the histologic evaluation lend support to the aforementioned clinical impression and clearly demonstrated a significant difference in the dimensions of the normal control ITs compared with those of the hypertrophic ITs.1 Moreover, the findings of normal mucosal and submucosal tissue constituents lacking features of edema or inflammation further support our assertion that these ITs represent appropriate examples of normal tissues and are therefore suitable for use as normal controls.

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June 1, 2007
Ronald Eccles, PhD
Arch Otolaryngol Head Neck Surg. 2007;133(6):624. doi:10.1001/archotol.133.6.624-a.
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