Inferior Turbinate Hypertrophy Grading in Chronic Allergic Rhinitis
The best method to measure inferior turbinate hypertrophy grade in chronic allergic rhinitis combines computed tomography (CT) measurements of turbinate width (anterior and posterior portions) with acoustic rhinometry for minimal cross-sectional area assessment.
Primary Measurement Approach
Use CT imaging to quantify turbinate dimensions systematically:
- Measure bilateral total width of the inferior turbinate 1
- Assess medial mucosa thickness in both anterior and posterior portions 1
- Calculate nasal cavity space dimensions 1
- Document measurements on both the affected and contralateral sides, as the contralateral side typically shows larger width than the deviated side in the anterior portion 1
Complementary Functional Assessment
Incorporate acoustic rhinometry for objective airflow data:
- Measure minimal cross-sectional area bilaterally 1
- Use active anterior rhinomanometry to document total nasal airway resistance (TNAR) and total nasal airflow (TNAF) 2
- These measurements provide functional correlation to anatomical findings and help guide treatment decisions 2
Clinical Grading Considerations
Important caveat: The degree of inferior turbinate hypertrophy shows no significant difference between allergic and non-allergic rhinitis patients 1. This finding challenges the assumption that allergy specifically augments turbinate size, meaning:
- Do not assume larger turbinates indicate allergic etiology 1
- Surgical planning for turbinate reduction should be based on symptom severity and objective measurements rather than allergy status alone 1
- Both allergic and non-allergic patients benefit similarly from turbinate reduction procedures 3, 4
Subjective Symptom Scoring
Supplement objective measurements with standardized visual analog scale (VAS) scoring (0-10 scale):
This combined approach allows correlation between anatomical hypertrophy and functional impairment, which is essential for treatment planning and outcome assessment 3, 2.