Exploring the Clinical Value and Implications of Routine Pathological Examination of Turbinate Specimens

Abstract

Objectives:

Inferior turbinate surgery for nasal obstruction can be performed in a variety of ways. Only a few of these methods produce tissue that can be sent for pathologic analysis. According to the College of American Pathologists (CAP), turbinate tissues are not exempt from pathology evaluation. Our objectives were to evaluate the clinical value and implications of routine pathological examination of turbinate specimens.

Methods:

A retrospective chart review was performed between January 2008 and August 2011 at a tertiary medical center for patients who underwent an inferior turbinate reduction procedure for nasal obstruction.

Results:

1,300 consecutive cases from 17 surgeons were identified. Among these patients, 223 (17%) underwent an isolated turbinate reduction procedure and 505 (39%) underwent a reduction procedure in conjunction with a septoplasty. The remaining had a turbinate reduction procedure in addition to another head and neck procedure. 591 (45%) of the turbinate reduction procedures were performed by methods that were tissue producing. Only 137 (23%) of these specimens were sent for pathologic analysis. All received a ‘gross’ examination and 123 (90%) also underwent histologic analysis. No abnormalities were reported in any of these specimens.

Conclusions:

In the majority of turbinate reduction procedures, there is no specimen produced for pathologic analysis. We found that most surgeons do not submit turbinate tissues for pathologic examination even when a specimen is produced, demonstrating a lack of clarity in the policy regarding the handling of turbinate tissues. We found no abnormal pathology results, which challenges the clinical utility in analyzing turbinate tissues removed in turbinate surgery for nasal obstruction.