Old and new aspects of middle turbinate histopathology

Objective: To study the histology of the normal and pathologic middle turbinate (MT). Study Design: Nonrandomized, controlled study. Subjects and Methods: Qualitative and quantitative assessment of soft tissue and bony elements of 14 normal and 10 chronic rhinosinusitis (CRS) MT samples (patients' mean CT score, 6.5 ± 6.7). A comparison with 14 normal inferior turbinate (IT) samples was accomplished. Quantitative assessment was limited to the lateral mucosal layer (LML). Results: The thickness of the LML was significantly greater in pathologic MT than in normal MT (P = 0.002). Except for veins that underwent significant increase (P = 0.036), other soft tissue constituents of the pathologic MT did not change significantly. Glands were more abundant in normal MT and veins in normal IT (P < 0.001, P = 0.001, respectively). Qualitative assessment showed larger veins in the normal IT compared with the normal MT. Inflammatory cell infiltrate, edema, and fibrosis were found in CRS. None of our MT bones exhibited osteomyelitic changes. Conclusions: The different proportion of glands suggests varied functional roles for both the MT and IT. The significant involvement of the MT in the inflammatory process of CRS and the relatively small size and paucity of veins with relatively little effect on nasal airflow justify partial excision of the MT.