A Comparative Study of Histopathology of the Inferior Turbinate in Chronic Rhinosinusitis With and Without Polyp

Abstract

Background: Hypertrophy of inferior turbinate (IT) may arise from soft tissue and/or bony enlargement and is most related to inflammatory rhinitis. We aimed to study and compare the histopathological changes in the IT mucosa, submucosa, and bone in chronic rhinosinusitis with (CRSwNP) and without nasal polyps (CRSsNP). Methods: The specimens of the IT in patients who underwent endoscopic sinus surgery and inferior turbinoplasty (ITplasty) were included and studied under the microscope in the high-power field. The changes in the mucosa, submucosa, and bone were studied, graded accordingly, and compared between the 2 groups. Results: In the mucosa, there was no significant difference in the polymorphonuclear neutrophils (PMN) and lymphocytic counts; however, the eosinophilic count in the mucosa was significantly higher in CRSwNP (P = .001). There was no significant difference in basement membrane thickness or subepithelial oedema. However, the lymphocyte count was higher in CRSsNP (P = .003), and the eosinophilic count was higher in CRSwNP (P = .001). The bone did not show inflammation. The significant osteitic changes in the bone were periosteal thickening with osteoblastic activity (P = .016). Conclusion: The mucosa and submucosa had a significant change in CRSwNP related to the eosinophilic infiltrates. In the submucosa, the lymphocyte count was significantly higher in CRSsNP. The osteitic changes seen were limited to periosteal thickening with minimal osteoblastic activity in both groups, but were significantly higher in CRSsNP. Hence, we can resect only the effected mucosa and spare bone during ITplasty in cases of CRSwNP, and IT bone may be partly resected in CRSsNP patients.