THE ROLE OF THE GROWTH FACTORS IN THE PATHOGENESIS OF COMPENSATORY TURBINATE HYPERTROPHY
1Hacettepe Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz Anabilim Dalı, Ankara, Turkey2Sağlık Bilimleri Üniversitesi Dışkapı Yıldırım Beyazıt SUAM, Kulak Burun Boğaz Kliniği, Ankara, Turkey
3Sağlık Bilimleri Üniversitesi Ankara Atatürk EAH, Patoloji Kliniği, Ankara, Turkey Introduction: Inferior turbinate hypertrophy (ITH) is oftenly associated with contolateral nasal septal deviation.This counterbalanced mechanism protects nasal mucosa from excess airflow which may cause drying and crusting.
Objectives: This study was designed to elucidate the roles of vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), basic fibroblast growth factor (b-FGF), nerve growth factor (NGF) and bone morphogenetic protein 2 (BMP-2) in the pathogenesis of compensatory contralateral turbinate hypertrophy accompanying nasal septal deviation in comparison between hypertrophied and normal turbinates.
Material and Methods: Forty nine cases with septal deviation and contralateral compensatory ITH who underwent septoplasty plus bilateral partial inferior nasal turbinate resection were included in this single center prospective study. Bilateral inferior turbinate specimens including tissue samples obtained from epithelium, submucosal duct, perivascular area and bone were collected for each patient to perform immuno-histochemical analysis of anti-VEGF, anti-EGF, anti-BMP-2, anti-b-FGF and anti-NGF positivity in the compensatory hypertrophied versus normal inferior turbinates.
Results: In both ITH group and normal turbinate group; tissue samples obtained from epithelium, submucosal duct, perivascular area and bone showed similar rates in anti-VEGF, anti-EGF, anti-b-FGF, anti-NGF and anti-BMP-2 scoring. There was no statistical significant difference between hypertrophied and normal inferior turbinates in terms of expression of growth factors. This study is one of the first to evaluate the contribution of growth factors in the compensatory ITH in patients with nasal septum deviation.
Conclusion: Present study revealed varying levels of expression for each growth factor in both turbinates, whereas no significant difference between hypertrophied and normal inferior turbinates in terms of expression of growth factors in tissue samples obtained from epithelium, submucosal duct, perivascular area and bone. Additional mechanisms and genetic alterations should be considered in further researches.
Keywords : Nasal concha, nasal septum, growth factors