European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 6, pp 1457–1467 | Cite as

Do turbinate reduction procedures restore epithelial integrity in patients with turbinate hypertrophy secondary to allergic rhinitis? A histopathological study

  • Vijaya Kumar Lukka
  • Tripti Meriel Jacob
  • Visalakshi Jeyaseelan
  • Vedantam Rupa



Consensus has not been reached regarding the optimal reduction procedure for inferior turbinate hypertrophy in allergic rhinitis and whether such procedures result in improvement in mucosal architecture.


Twenty-nine patients aged 18–45 years (mean 26.8 years), with allergic rhinitis and inferior turbinate hypertrophy not responsive to medical therapy who underwent endoscopic submucosal diathermy (ESMD) (14 patients) or endoscopic submucosal resection (ESMR) (15 patients) with intraoperative and 3–6 months postoperative inferior turbinate biopsies, were included in the study. Epithelial and mucosal architecture was compared between the two groups.


Both groups showed a significant decrease in epithelial denudation (p < 0.001), reversal of basement membrane thickening (p < 0.001) and increase in density of cilia (p < 0.001). The degree of improvement in histological characteristics between ESMD and ESMR groups was not significant.


Surgical intervention for inferior turbinate hypertrophy by both ESMD and ESMR results in significant restoration of nasal mucosal epithelium in patients with allergic rhinitis as early as 3-month postoperatively. There was, however, no significant difference in the histological changes between those who underwent ESMD and ESMR.

Clinical Trials of India, Registry Number



Inferior turbinate Submucosal diathermy Submucosal resection Histopathology Epithelial denudation Fibrosis 



The authors would like to acknowledge Ms. Malavika B., Department of Biostatistics, Christian Medical College, Vellore, India, who provided help with statistical analysis for this paper.


This project was funded by an institutional research Grant (IRB no. 9170), Christian Medical College, Vellore.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to declare.

Supplementary material

405_2018_4955_MOESM1_ESM.xls (88 kb)
Supplementary material 1 (XLS 87 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of ENTChristian Medical CollegeVelloreIndia
  2. 2.Department of AnatomyChristian Medical CollegeVelloreIndia
  3. 3.Department of Anatomy, School of Medical SciencesUNSWSydneyAustralia
  4. 4.Department of BiostatisticsChristian Medical CollegeVelloreIndia

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