Is turbinate surgery necessary when performing a septoplasty?

Many otolaryngologists perform septoplasty with or without turbinate surgery and the surgical method relies largely on the surgeon's clinical judgment. This study used computed tomography (CT) of the sinuses of 20 patients to examine the correlation between a unilateral deviated nasal septum and compensatory hypertrophy of the contralateral inferior turbinate to suggest guidelines for septal and turbinate surgery. The thickness of the mucosa and conchal bone, the projection angle of the conchal bone, and the distances between the conchal bone, and lateral nasal line and median line were measured. The volume of the inferior turbinate was measured from the three-dimensional reconstruction. Each measurement was compared with those of the nasal cavity on the contralateral and of normal control subjects. The inferior turbinate on the concave side had a significantly greater volume, including the thickness of medial mucosa and the thickness and projection angle of conchal bone. Septoplasty and concomitant inferior turbinate surgery to manipulate conchal bone and soft tissues are necessary for treatment of those patients with unilateral nasal septal deviation and compensatory hypertrophy of the contralateral inferior turbinate.

Induction of chondrogenic differentiation in cultured fibroblasts isolated from the inferior turbinate.

OBJECTIVES: To explore options of cell sources for regeneration of cartilage, turbinate fibroblasts were tested for their differentiation potential when cultured in three-dimensional scaffolds with growth factors and co-cultured with septal chondrocytes. METHODS: Fibroblasts and chondrocytes were seeded on to an alginate sponge in different proportions and were stimulated with TGF-beta1 and IGF-I. Chondrogenic differentiation of fibroblasts was assessed by histology including immunohistochemical staining, which was examined by reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: Chondroid cells with extracellular matrices occupied the porous structures of alginate sponge and immunolocalizations for type II collagen became prominent at four weeks in culture. Expression of type II collagen and aggrecan mRNA were detected by RT-PCR. Co-culture of fibroblasts and chondrocytes showed comparable expansion of cells and extracellular matrix to culture of chondrocytes only. CONCLUSION: These findings suggest that human turbinate fibroblasts are apparently redirected toward chondrogenic phenotype by in vitro culture system under specific conditions. Co-culture of turbinate fibroblasts with septal chondrocytes would be an effective method to expand cartilage specific extracellular matrix.