Allergic rhinitis improvement after septorhinoplasty in a sample of allergic rhinitis patients with septal deviation: a quasi-experimental study

Abstract

INTRODUCTIONAllergic rhinitis (AR) is a chronic inflammatory disease that affects almost 30% of the adult population and is associated with other inflammatory diseases. 1 In AR, the upper airway respiratory mucosa becomes inflamed in response to allergen exposure, mediated by the T helper 2 (Th2) immunological response. Common symptoms include sneezing, rhinorrhea, nasal congestion, nasal itching and nasal obstruction. Nasal obstruction is the symptom that is most refractory to medical treatment. 2 The evolution of AR includes chronic rhinosinusitis, nasal polyposis or chronic rhinitis. 3 Despite the high prevalence of AR and the variety of medications for treating it, many patients still feel that their treatment has failed. 4 AR impairs quality of life (QoL) and work productivity, since it is an important cause of absence from work and school, and it generates huge costs in prescription medication. 5 Deviation of the nasal septum is diagnosed in more than 70% of the general population to some degree. 6 It causes symptoms such as nasal obstruction, epistasis, snoring, anxiety, headaches, buccal breathing and sinusitis. 7,8 Septorhinoplasty (STP) is the most common treatment for patients with septal deviation and generally gives rise to satisfactory outcomes. 9The treatments for AR include avoidance of the causative allergen, a great variety of medications (such as antihistamines, anti-leukotrienes or corticoids) and specific allergen immunotherapy. These conservative methods lead to improvement of symptoms but, for some refractory patients, medication alone is not enough. The surgical procedures for treating AR include cryotherapy, laser cautery, sinus surgery or turbinate resection. AR guides do not nowadays include

Efficacy of various surgical methods in the treatment of allergic rhinitis: A network meta-analysis

“…The therapeutic mechanism of AEN is similar to that of PNN and VN. 63 It achieves its goal by blocking the sensation of abnormal stimulation and inhibiting the secretion of inflammatory mediators. 64 Our study found that the efficacy and symptom and sign scores of AEN in the treatment of AR patients without chronic rhinosinusitis and nasal polyps were lower than those of PNN and VN, which may be related to the fact that its innervation of the mucosa is smaller than that of the posterior nasal nerve.…”