A New Insight for Evaluation of the Inferior Turbinate With Ultrasound Elastography

Objectives-There are diseases that affect the stroma of the inferior turbinate and many surgical interventions that alter it. However, an objective method that can evaluate the turbinate's stromal structure in detail has not been defined yet. The primary aim of this study was to investigate the effectiveness and reliability of ultrasound elastography for objective evaluation of the inferior turbinate stroma and define the most suitable elastographic technique. Methods-Twenty inferior turbinates in 10 healthy participants were included. Five of the participants (50%) were male, and 5 (50%) were female, with a mean age +/- SD of 28.3 +/- 3.2 years (range, 26-35) years. To obtain reliable and reproducible results, elastography was performed twice, 3 days apart, with and without a topical decongestant to evaluate the effects of the nasal cycle and mucosal edema. Two previously described valid elastographic outcome measures were reevaluated for the inferior turbinate. The tissue strain ratio and sound wave propagation speed were calculated for each measurement. Results-Median propagation speeds without and with the decongestant for the first and second measurements were 2.125 (interquartile range [IQR], 0.85), 2.175 (IQR, 0.53), 2.520 (IQR, 0.79), and 2.555 (IQR, 0.53) m/s, respectively. Median turbinate stroma-to-subcutaneous tissue strain ratios without and with the decongestant for the first and second measurements were 1.402 (IQR, 0.96), 0.942 (IQR, 0.24), 1.035 (IQR, 0.98), and 1.427 (IQR, 1.68). Conclusions-We suggest that elastography is a reliable and reproducible method that is not substantially affected by mucosal edema. It is a novel technique that can evaluate the inferior turbinate stroma and might be used in concordance with other objective functional techniques such as acoustic rhinometry. Therefore, it can be used in further studies regarding diagnosis of turbinate diseases and objective evaluation of previous surgical treatments.