Unilateral inferior turbinate bone hypertrophy: is it compensatory or congenital?

This study evaluates the degree of the unilateral hypertrophied inferior turbinate (HIT) by computed tomography (CT) and determines and compares the enlargement of the turbinate bone and soft tissue in different parts of the HIT in pediatric and adult groups.

Both pediatric and adult patients were studied in two groups: those with a straight or nearly straight septum (n = 25 and 124, respectively) and those with deviation (n = 64 and 129, respectively). The cross-sectional area (CSA) of the IT bone and soft tissue were measured at anterior, middle, and posterior thirds of the IT in coronal CT sections. The ratio of CSA of the IT bone and soft tissue on two sides of the septum (interturbinate ratio [IR]) were calculated. IRs were then compared among straight septum and deviation groups for both the pediatric and the adult groups.

IR of the bony concha CSA for the deviation group was significantly higher compared with the straight septum group in anterior, middle, and posterior segments in adults (p = 0.028, 0.018, and <0.001, respectively; independent samples t-test). The soft tissue component hypertrophy was prominent only in the middle segment (p = 0.15); however, there was no significant difference for pediatric patients. Also, there was a statistically significant difference between the adult group with septum deviation and the pediatric group with septum deviation for both soft tissue and bone components (p < 0.001 for all segments; independent samples t-test).

We claim that these results indicate that skeletal and soft tissue IT hypertrophy seem to be compensatory and evolves with age rather than being congenital. Therefore, skeletal enlargement is prominent in anterior, middle, and posterior thirds of HIT in patients with septal deviation in adults but not in the pediatric group.