Anatomical features of the inferior nasal concha hypertrophy in children

Background: The article presents a study concerning the inferior nasal concha (INC) hypertrophy in children, which is currently a poorly studied problem. This pathology is one of the chronic nasal obstruction causes having a significant negative effect on the nasolacrimal duct functional state. Hypertrophy of INC is often combined with the nasal septum (NS) deformation and can occur with the predominance of soft tissue or bone components.

Purpose: to study the anatomical features of hypertrophied INC in children with or without concomitant deformation of NS.

 Material and methods: a retrospective assessment of the paranasal sinuses computed tomography results was performed for 112 children aged 9 to 17 years. Patients were divided into two groups: the first group consisted of 68 (60.7%) children with INC hypertrophy and even nasal septum; the second group — 44 (39.3%) children with INC hypertrophy and deformed nasal septum. The morphometric parameters of the INC were defined (the volume of the anterior, middle, and posterior thirds of concha, the cross-sectional area of the soft and bony concha tissues in mm2). The results were statistically analyzed. Patients were followed up for two years, with otorhinolaryngological examination carried out every three months.

Results. In 97.3% of cases hypertrophy of the soft-tissue component of the INC was seen, which was mostly observed in its middle part, but also in the anterior and posterior segments. A one-sided increase in the INC volume was detected mainly in children with NS deformation and mostly on the side contralateral to it. Conclusion: This work revealed the hypertrophy of INC soft tissues in all patients, a one-sided increase in the INC volume observed in children with concomitant NS deformations. The results of morphometric measurements indicate that INC hypertrophy is not congenital; it develops with age being compensated. Because the compensation mechanism in children mainly affects the soft tissue of the INC, the optimal surgical approach for reducing the volume of the INC should be based on the destruction of soft tissues (submucosal shaver or laser turbine plastics, etc.) while bone resection is not reasonable.

Keywords: inferior nasal concha, middle nasal concha, nasal septum, hamulus, nasolacrimal canal, computed tomography of the paranasal sinuses, nasal septum deformation, hypertrophy of the inferior nasal concha, submucosal shaver turbine plastics, submucosal laser turbine plastics

The authors declare no conflict of interest. Source of financing: not specified.

For citation: Baranov K.K., Zyabkin I.V., Pikhurovskaya A.A., Bogomilsky M.R. Anatomical features of the inferior nasal concha hypertrophy in children. Golova i sheya. Rossijskij zhurnal Head and neck. Russian Journal. 2019;7(3):23–27 (in Russian).

The authors are responsible for the originality of the data presented and the possibility of pub-lishing illustrative material – tables, figures, photographs of patients.

摘要

背景：本文展示了关于儿童下鼻甲（INC）肥大的研究，有关该问题的研究目前还不完善。这种病理状态是造成慢 性鼻阻塞的原因之一，其对鼻泪管的功能具有显着的负面影响。下鼻甲的肥大通常与鼻中隔（NS）变形相结合， 并可能以软组织或骨性成分肥大为主。

目的：研究单纯儿童下鼻甲肥大或与鼻中隔变形相结合的解剖特征 材料和方法：对112例9至17岁的儿童进行了鼻旁窦计算机断层扫描结果的回顾性评估。患者分为两组：第一组由 68名（60.7％）患有下鼻甲肥大甚至鼻中隔肥大的儿童组成。第二组-44名（39.3％）由儿童下鼻甲肥大和鼻中 隔畸形的患者组成。下鼻甲的形态学参数（前、中、后鼻甲的体积，软性和骨性鼻甲的横截面积，单位是平方毫 米）。作者对结果进行了统计分析，并对患者进行了两年的随访，每三个月进行一次耳鼻喉检查。

 

结果：在97.3％的病例中，观察到下鼻甲的软组织成分肥大，主要在其中间部分，但是在前部和后部也可见。在 大多数患有鼻中隔变形的儿童中观察到了下鼻甲体积的单侧增大，并且增大多见于鼻中隔变形的对侧

 

结论：这项工作揭示了所有患者中下鼻甲软组织的肥大，在伴随鼻中隔变形的儿童中观察到的下鼻甲体积一侧增 加。形态测量结果表明，下鼻甲肥大不是先天性的。它随着年龄的增长而发展。由于儿童的补偿机制主要影响下 鼻甲的软组织，因此减少下鼻甲体积的最佳手术方法应基于在进行骨切除术时破坏软组织（粘膜下剃刀或激光涡 轮整形术等），然而骨切除术是不合理的。

关键词：下鼻甲，中鼻甲，鼻中隔，钩骨，鼻泪管，鼻旁窦的计算机断层扫描，鼻中隔变形，下鼻甲肥大，粘膜 下剃刀涡轮整形术，粘膜下激光涡轮整形术

 

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引用：Baranov K.K., Zyabkin I.V., Pikhurovskaya A.A., Bogomilsky M.R. Anatomical features of the inferior nasal concha hypertrophy in children. Golova i sheya. Rossijskij zhurnal = Head and neck. Russian Journal. 2019;7(3):23–27 (in Russian).

 

作者对所提供数据的独创性以及发布说明性材料（表格，图表，患者照片）的可能性负责。

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