Inferior Turbinate Reduction during Rhinoplasty: Is There Any Effect on Rhinitis Symptoms?

Abstract

Introduction Inferior turbinate surgery is often performed concomitantly with rhinoseptoplasty. As inferior turbinates play a major role in allergic rhinitis, it seems reasonable to suggest that inferior turbinate surgery reduces allergy. Objective To assess the impact of nasal turbinate surgery on non-obstructive allergic symptoms (nasal discharge, sneezing, pruritus, and allergic conjunctivitis) and on the use of allergic medication in patients with allergic rhinitis undergoing rhinoseptoplasty. Methods Secondary analysis of aggregated data from two randomized controlled trials. Participants with allergic rhinitis aged ≥ 16 years were recruited. Data from two groups were analyzed: patients with rhinoseptoplasty and concomitant turbinate reduction (intervention group) and patients with rhinoseptoplasty only (control group). The 90-day postoperative frequency of non-obstructive allergic symptoms and of nasal steroid and oral antihistamine use were analyzed. Results A total of 100 patients were studied. The groups were similar in terms of allergic symptom intensity and mean age. The frequency of non-obstructive allergic symptoms decreased 90 days postoperative in both groups (p < 0.01). There was no difference between the groups in the frequency of non-obstructive allergic symptoms at 90 days (p = 0.835). Topical nasal steroid and oral histamine antagonist use decreased in the intervention group at 90 days (p < 0.05). Conclusions Ninety days after the surgery, turbinate reduction performed in association with rhinoseptoplasty did not reduce the frequency of non-obstructive allergic symptoms more than rhinoplasty alone. However, the observed decrease in nasal steroid and oral antihistamine use suggests an impact of turbinate reduction on medication use in patients with allergic rhinitis undergoing rhinoseptoplasty. Trial Registration ClinicalTrials.gov database (NCT01457638 and NCT02231216).

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

“…Recent studies 50,69 have shown that NSR + BIT and NSR have no statistical difference in the improvement of nonobstructive allergic symptoms, which was consistent with our results. But after a network meta-analysis, we found that its ranking was higher than NSR.…”

Comparison of Allergen Immunotherapy Alone and in Conjunction With Turbinate Surgery for Nasal Obstruction in Perennial Allergic Rhinitis Patients

“…It is important to note that the key players driving the severity of AR symptoms are both allergic mucosa inflammation in the inferior turbinates as well as increased turbinate size. 23 As such, symptom relief may require these 2 factors contributing to refractory nasal obstruction to be targeted. Currently, patients with AR are often treated by only allergist or ENT surgeons, with minimal overlap, and therefore will be directed to AIT or ITR preferentially.…”

“…It is important to note that the key players driving the severity of AR symptoms are both allergic mucosa inflammation in the inferior turbinates as well as increased turbinate size. 23 As such, symptom relief may require these 2 factors contributing to refractory nasal obstruction to be targeted.…”