Long-term Outcomes of Turbinate Surgery in Patients With Allergic Rhinitis

Park, Sang Chul; Kim, Do Hyun; Jun, Young Joon; Kim, Soo Whan; Yang, Hyeon‐Jong; Yang, Song-I; Kim, Hyun Jung; Kim, Dong Kyu

doi:10.1001/jamaoto.2022.3567

Cited by 4 publications

(5 citation statements)

References 47 publications

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“…This meta‐analysis study excluded the effect of neurectomy which is also not performed in our septomeatoplasty patients. The findings showed significant changes in symptom scores before and after the procedure, demonstrating mean differences as follows: nasal obstruction (4.60), rhinorrhea (3.12), sneezing (2.64), and itching (1.75) 13 . It is clear that nasal obstruction experienced the most significant improvement.…”

Section: Discussionmentioning

confidence: 91%

“…There was a meta‐analysis of long‐term outcomes among 1411 AR patients after turbinate surgery analyzed the self‐rate symptom scores 13 . This meta‐analysis study excluded the effect of neurectomy which is also not performed in our septomeatoplasty patients.…”

Section: Discussionmentioning

confidence: 99%

“…According to a previous study, sneezing may be less likely to persist after surgery. A meta‐analysis of long‐term surgical outcomes in patients with AR showed that surgery has a positive impact on controlling nasal obstruction and rhinorrhea for over three years, whereas the improvements in sneezing symptoms were noticeable from three months to three years 13 . A four‐year follow‐up of patients with AR who underwent microdebrider‐assisted inferior turbinoplasty and a five‐year follow‐up of patients with AR who underwent radiofrequency turbinoplasty revealed that some patients might experience refractory symptoms to a certain extent.…”

Section: Discussionmentioning

confidence: 99%

“…12 There was a meta-analysis of long-term outcomes among 1411 AR patients after turbinate surgery analyzed the self-rate symptom scores. 13 This meta-analysis study excluded the effect of neurectomy which is also not performed in our septomeatoplasty patients. The findings showed significant changes in symptom scores before and after the procedure, demonstrating mean differences as follows: nasal obstruction (4.60), rhinorrhea (3.12), sneezing (2.64), and itching (1.75).…”

Section: Slit Effect On Different Symptomsmentioning

confidence: 99%

“…The findings showed significant changes in symptom scores before and after the procedure, demonstrating mean differences as follows: nasal obstruction (4.60), rhinorrhea (3.12), sneezing (2.64), and itching (1.75). 13 It is clear that nasal obstruction experienced the most significant improvement. However, the symptoms of rhinorrhea, sneezing, and itching also exhibited enhancements in their respective scores following turbinate surgery.…”

Section: Slit Effect On Different Symptomsmentioning

confidence: 99%

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Efficacy of Adjuvant Sublingual Immunotherapy After Septomeatoplasty

Hsieh,

Kuo,

Yong

et al. 2024

The Laryngoscope

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BackgroundThe efficacy of adjuvant sublingual immunotherapy (SLIT) in correcting structural problems in patients with allergic rhinitis (AR) caused by mite who have undergone septomeatoplasty (SMP) has not been studied.MethodsThis non‐randomized controlled study recruited patients with AR (caused by mite) and concurrent septal deviation and inferior turbinate hypertrophy, at a tertiary hospital in Taiwan. SMP was performed on all patients as a surgical intervention. The patients were then divided into two groups: the control group, which underwent surgery only, and the experimental group, which received SLIT as an adjuvant treatment. Demographic data and rhinitis control assessment test (RCAT) results were analyzed.ResultsA total of 96 patients were enrolled in the study (SMP + SLIT group, n = 52; SMP only group, n = 44). No significant differences were observed in any of the variables between the two groups before and one month after surgery. However, during evaluations at the third and sixth month, the SMP + SLIT group showed significant improvement in the total RCAT scores compared to the SMP only group (28.6 ± 1.56 vs. 24.5 ± 3.66, p < 0.001; 27.1 ± 2.87 vs. 19.9 ± 5.56, p < 0.001). In addition, significantly better control of all RCAT sub‐categories was observed in the SMP + SLIT group at the third and sixth month evaluations.ConclusionsSLIT may serve as an ideal adjuvant therapy after SMP in patients with AR.Level of EvidenceLevel 3 Laryngoscope, 2024

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Slit Effect On Different Symptomsmentioning

confidence: 99%

Section: Slit Effect On Different Symptomsmentioning

confidence: 99%

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Efficacy of Adjuvant Sublingual Immunotherapy After Septomeatoplasty

Hsieh,

Kuo,

Yong

et al. 2024

The Laryngoscope

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In Response to Cost‐effectiveness Analysis of Inferior Turbinate Reduction and Immunotherapy in Allergic Rhinitis

Yong,

Aravinthan,

Kirubalingam

et al. 2023

The Laryngoscope

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We are pleased that the EUFOREA Expert Panel has shared their opinion, as a multispecialty approach to allergic rhinitis (AR) is necessary to expand the options available to patients. 1 Although inferior turbinate reduction (ITR) has traditionally been viewed as a procedure strictly targeting nasal obstruction, there is an evolving understanding that modern techniques can provide additional benefits with a low rate of complications. ITR for the treatment of AR has now been shown to significantly improve sneezing and rhinorrhea which is sustained beyond 1 year after surgery. 2 Additionally, the role of the inferior turbinate in nonallergic rhinitis is being increasingly recognized. Submucous resection may have a beneficial effect through the disruption of overactive parasympathetic neurovascular supply in the inferior turbinate. 3 Furthermore, ITR techniques have evolved over time and no longer involve radical mucosal resection, but rather mucosalsparing techniques such as controlled ablation or removal of the submucous tissues. These approaches preserve the function but dampen the reactivity of the turbinate. 4,5 Allergen immunotherapy (AIT) remains an important treatment for patients as it can modify the underlying immune response. However, consideration of ITR as an upfront or concurrent treatment would only serve to expand available options for patients, as ITR would not preclude allergy testing and AIT. ITR may offer a more immediate effect when compared to the time it typically takes to perform allergen testing and reach AIT maintenance dosing. 6 Furthermore, ITR may be beneficial to patients who are not candidates for AIT. In addition, although there has been some exploration of the link between untreated AR and the development of asthma, there has not been a causative link identified. 7,8 It could be postulated that because the inferior turbinate itself plays a major role as the first anatomic structure which samples inspired air, dampening of its reactivity by way of ITR may alter the progression of AR and, by extension, asthma. However, this discussion remains speculative.Lastly, we believe that the results of the analysis reflect a real-world approach to clinical decision-making. Testing such as acoustic rhinometry is rarely if at all performed in the clinical setting and does not affect the decision to proceed with ITR. 9 Additionally, although societal factors such as losses of productivity were not captured in the analysis, these factors would be applicable to both ITR and AIT, as the societal costs of referral delays, AIT rampup period, and nonresponse would be nontrivial.

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