The Role of Nasal Cytology in the Management of Inferior Turbinate Hypertrophy

Inferior turbinate hypertrophy (ITH) is the main cause of nasal obstruction symptom. This study aimed at investigating whether a particular cellular pattern could be a predictive factor for failure of medical treatment for ITH in patients with rhinitis. Globally, 258 patients with chronic nasal obstruction due to ITH were evaluated by: visual analogue scale assessment of symptoms, skin prick tests, fiber-endoscopy, active anterior rhinomanometry, and nasal cytology. All patients were treated with drugs for 3 months and then re-evaluated. The symptom improvement depended on the different cellular pattern. There was improvement in: 54 (51.4%) patients with allergic rhinitis, 72 (69.2%) with non-allergic rhinitis with neutrophils (NARNE), 15 (42.8%) with non-allergic rhinitis with eosinophils (NARES), and 9 (64.3%) with non-allergic rhinitis with mast cells/non-allergic rhinitis with eosinophils and mast cells (NARMA/NARESMA). The non-responders (108; 41.9%) were therefore directed towards surgical treatment. Both patients with allergic rhinitis and patients affected by NARES had a higher failure rate to medical treatment compared with NARMA and NARESMA groups (p<0.01). In conclusion, elevated number of eosinophils, in the nasal secretion of both allergic (allergic rhinitis) and non-allergic (NARES) patients with ITH, can be associated to a higher medical treatment failure rate.