Anatomical Factors Affecting Outcome of Outfracture of the Inferior Turbinate: Radiologic Analysis

Sang-Hyun Park; Min Yun; Ji-Hun Mo; Young-Jun Chung

doi:10.18787/jr.2015.22.1.34

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Park, Yun, Mo, and Chung: Anatomical Factors Affecting Outcome of Outfracture of the Inferior Turbinate: Radiologic Analysis

Original Article

J Rhinol 2015;22(1):34-40.

Published online: 10 January 2015

DOI: https://doi.org/10.18787/jr.2015.22.1.34

Anatomical Factors Affecting Outcome of Outfracture of the Inferior Turbinate: Radiologic Analysis

Sang-Hyun Park, MD, Min Yun, MD, Ji-Hun Mo, MD, Young-Jun Chung, MD

Department of Otorhinolaryngology-Head & Neck Surgery, Dankook University College of Medicine, Cheonan, Korea

교신저자：정영준, 330-715 충남 천안시 동남구 망향로 201단국대학교 의과대학 이비인후-두경부외과학교실Tel: +82-41-550-3974, Fax: +82-41-556-1090 E-mail: docjung@paran.com

Received 29 October 2014 Revised 18 November 2014 Accepted 25 January 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Objectives

：Outfracture of the inferior turbinate (IT) is a less invasive procedurethan all other reductive turbinate surgeries. The aim of this study is to investigate the anatomical factors of IT affecting outcomes of outfracture of the IT. Materials and Method： This study comprises 206 cases of 103 patients who underwent outfracture from 2006 to 2012. Patients weregrouped according to good outcome and poor outcome, based on postoperative endoscopic assessments after decongestion. Angle and length of IT, width of IT head, and the distance of the IT to the lateral nasal wall were compared at three different sections viacomputed tomography. Results： Significant differences in the length and angle of IT between the two groups were not found. The width of the IT head in the good outcome group was narrower than that in the poor outcome group. The distance of the IT to the lateral nasal wall was longer in the good outcome group, compared with that of the poor outcome group. These differences were especially prominent at the middle and posterior sections. Conclusion： This study suggests that some anatomical factors, especially the width of the inferior meatus, could play a role in affecting the outcome of outfracture IT surgery.

Keywords: Turbinate, Surgery, Treatment outcome, Anatomy, Computed tomography.

References

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Fig. 1.

Preoperative (A and C) and post-operative (B and D) endoscopic photographs of the good outcome patient (A and B) and poor outcome patient (C and D).

Fig. 2.

A: The anterior section is the first scan, which could be seen entire inferior turbinate bone. B: The middle section is the scan at the level of the maxillary sinus ostium. C: The posterior section is the last scan, which could be seen entire the inferior turbinate bone.

Fig. 3.

Measurement of the angle, length of the inferior turbinate. A: 1st angle. B: 2nd angle. C: 1st length. D: 2nd length.

Fig. 4.

The thickness of the inferior turbinate. A: Conchal bone. B: Medial mucosa. C: Lateral mucosa. D: Width of Head.

Fig. 5.

Distances between the inferior turbinate bone and the lateral nasal wall. A: The anterior section. B: The middle section. C: The posterior section.

Table 1.

Angles and lengths at the anterior, middle and posterior sections of the inferior turbinate

	Anterior section		p value	Middle section		p value	Posterior section		p value
	Good	Poor	p value	Good	Poor	p value	Good	Poor	p value
1st Angle (°)	72.81±4.77	74.26±6.36	0.525	87.29±1.37	86.14±1.92	0.831	77.44±2.50	71.52±3.09	0.418
2nd Angle (°)	99.41±1.66	96.72±2.39	0.970	114.68±1.22	118.61±2.25	0.109	102.64±2.65 1	106.36±4.07	0.928
1st length (mm)	6.76±0.19	7.25±0.27	0.926	8.85±0.21	8.32±0.30	0.584	9.89±0.33	9.5±0.45	0.084
2nd length (mm)	5.58±0.18	5.7±0.26	0.566	7.03±0.20	7.01±0.23	0.527	7.74±0.27	7.05±0.46	0.580

Table 2.

Bony thickness, medial mucosa, lateral mucosa and width of the head of the inferior turbinate at the anterior, middle and posterior sections

	Anterior section		p value	Middle section		p value	Posterior section		p value
	Good	Poor	p value	Good	Poor	p value	Good	Poor	p value
Width of IT (mm)	10.35±0.28	11.21±0.29	0.226	10.32±0.21	11.24±0.30	0.011	8.98±0.20	9.43±0.32	0.009
Bony thickness (mm)	2.86±0.92	2.82±0.11	0.802	3.03±0.94	3.30±0.14	0.108	2.24±0.09	2.27±0.11	0.837
Medial mucosa (mm)	3.89±0.12	4.22±0.19	0.139	4.13±0.13	4.52±0.20	0.093	4.24±0.15	4.61±0.20	0.154
Lateral mucosa (mm)	3.60±0.12	4.17±0.20	0.012	3.16±0.10	3.42±0.12	0.134	2.50±0.11	2.55±0.12	0.753

IT: inferior turbinate

Table 3.

Width of the inferior meatus at the anterior, middle and posterior sections of the inferior turbinate

	Anterior section		p value	Middle section		p value	Posterior section		p value
	Good	Poor	p value	Good	Poor	p value	Good	Poor	p value
Width of inferior meatus (mm)	6.23±0.14	6.53±0.22	0.057	7.22±0.15	6.71±0.17	0.024	5.58±0.18	5.01±0.17	0.028

Table 4.

Comparison of surgical outcome between good and poor outcome groups according to the degree of septal deviation

Degree of septal deviation (angle)	Concave side		p value	Convex side		p value
Degree of septal deviation (angle)	Good	Poor	p value	Good	Poor	p value
≤9°	45	18	0.732	44	19	0.180
9–15°	20	10		19	11
＞ 15°	06	04		04	06

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