Outcome of Submucosal Inferior Turbinoplasty in Perennial Allergic Rhinitis

Overview

Journal Indian J Otolaryngol Head Neck Surg

Publisher Springer

Date 2022 Dec 1

PMID 36452565

Authors

P K Anjali

S M Azeem Mohiyuddin

K C Prasad

S Chandrakala

M Shree Harsha

K Abhilasha

Affiliations

Soon will be listed here.

Abstract

Pharmacotherapy forms mainstay of treatment for allergic rhinitis, and has adverse effects associated with it. Topical steroid therapy is the preferred medication and considered best for long term prophylaxis but with limited compliance. Submucosal turbinoplasty reduces the duration of treatment in comparison to topical steroid which has to be taken daily for a long time. The aim was to evaluate the outcome of submucosal inferior turbinoplasty in patients with perennial allergic rhinitis. A prospective interventional study was performed on 35 patients diagnosed with perennial allergic rhinitis, diagnosed as per ARIA criteria from July 2016 to July 2018. The severity of the disease was assessed using mini RQLQ scoring system. The patients were then subjected to bilateral submucosal inferior turbinoplasty under endoscopic guidance under local anesthesia. 50% significant improvement ( value < 0.05) seen in symptoms were need to blow nose, sneezing, nasal obstruction, nasal discharge, watery eyes, need to rub eye, regular house work, recreational activities, sore eyes, tiredness, irritability and thirst. 100% improvement ( value < 0.05) seen in symptoms were sleep, need to blow nose, sneezing, nasal discharge, watery eyes, need to rub eye, recreational activities and irritability. Nasal obstruction was not severe in 17 (48.5%) patients giving a very good symptom relief and improving quality of life. This is due to reduction in the erectile tissue and roominess in the nasal cavity. All patients with allergic rhinitis with associated hypertrophied turbinates should invariably be given option of inferior turbinoplasty along with proper counselling regarding its advantages and disadvantages.

References

Scadding G . Optimal management of allergic rhinitis. Arch Dis Child. 2015; 100(6):576-82. PMC: 4514979. DOI: 10.1136/archdischild-2014-306300. View

Chen Y, Tan C, Huang H . Long-term efficacy of microdebrider-assisted inferior turbinoplasty with lateralization for hypertrophic inferior turbinates in patients with perennial allergic rhinitis. Laryngoscope. 2008; 118(7):1270-4. DOI: 10.1097/MLG.0b013e31816d728e. View

Carrie S, Wright R, Jones A, Stevens J, Parker A, Yardley M . Long-term results of trimming of the inferior turbinates. Clin Otolaryngol Allied Sci. 1996; 21(2):139-41. DOI: 10.1111/j.1365-2273.1996.tb01318.x. View

Bhandarkar N, Smith T . Outcomes of surgery for inferior turbinate hypertrophy. Curr Opin Otolaryngol Head Neck Surg. 2009; 18(1):49-53. DOI: 10.1097/MOO.0b013e328334d974. View

El Henawi D, Ahmed M, Madian Y . Comparison between power-assisted turbinoplasty and submucosal resection in the treatment of inferior turbinate hypertrophy. ORL J Otorhinolaryngol Relat Spec. 2011; 73(3):151-5. DOI: 10.1159/000327607. View

Schoenwetter W . Allergic rhinitis: epidemiology and natural history. Allergy Asthma Proc. 2000; 21(1):1-6. DOI: 10.2500/108854100778248971. View

Mucci S, Sismanis A . Inferior partial turbinectomy: an effective procedure for chronic rhinitis. Ear Nose Throat J. 1994; 73(6):405-7. View

Mori S, Fujieda S, Yamada T, Kimura Y, Takahashi N, Saito H . Long-term effect of submucous turbinectomy in patients with perennial allergic rhinitis. Laryngoscope. 2002; 112(5):865-9. DOI: 10.1097/00005537-200205000-00016. View

Chen Y, Liu C, Huang H . Comparison of microdebrider-assisted inferior turbinoplasty and submucosal resection for children with hypertrophic inferior turbinates. Int J Pediatr Otorhinolaryngol. 2007; 71(6):921-7. DOI: 10.1016/j.ijporl.2007.03.002. View

10.

Neri G, Cazzato F, Mastronardi V, Pugliese M, Centurione M, Di Pietro R . Ultrastructural regenerating features of nasal mucosa following microdebrider-assisted turbinoplasty are related to clinical recovery. J Transl Med. 2016; 14(1):164. PMC: 4898366. DOI: 10.1186/s12967-016-0931-8. View

11.

Fradis M, Malatskey S, Magamsa I, Golz A . Effect of submucosal diathermy in chronic nasal obstruction due to turbinate enlargement. Am J Otolaryngol. 2002; 23(6):332-6. DOI: 10.1053/ajot.2002.126857. View

12.

Sapci T, Sahin B, Karavus A, Akbulut U . Comparison of the effects of radiofrequency tissue ablation, CO2 laser ablation, and partial turbinectomy applications on nasal mucociliary functions. Laryngoscope. 2003; 113(3):514-9. DOI: 10.1097/00005537-200303000-00022. View

13.

Garth R, Cox H, Thomas M . Haemorrhage as a complication of inferior turbinectomy: a comparison of anterior and radical trimming. Clin Otolaryngol Allied Sci. 1995; 20(3):236-8. DOI: 10.1111/j.1365-2273.1995.tb01856.x. View

14.

Cobanoglu B, Toskala E, Ural A, Cingi C . Role of leukotriene antagonists and antihistamines in the treatment of allergic rhinitis. Curr Allergy Asthma Rep. 2013; 13(2):203-8. DOI: 10.1007/s11882-013-0341-4. View

15.

Ophir D, Shapira A, MARSHAK G . Total inferior turbinectomy for nasal airway obstruction. Arch Otolaryngol. 1985; 111(2):93-5. DOI: 10.1001/archotol.1985.00800040057006. View

16.

Varshney J, Varshney H . Allergic Rhinitis: an Overview. Indian J Otolaryngol Head Neck Surg. 2015; 67(2):143-9. PMC: 4460099. DOI: 10.1007/s12070-015-0828-5. View

17.

Fradis M, Golz A, Danino J, Gershinski M, Goldsher M, Gaitini L . Inferior turbinectomy versus submucosal diathermy for inferior turbinate hypertrophy. Ann Otol Rhinol Laryngol. 2000; 109(11):1040-5. DOI: 10.1177/000348940010901109. View

18.

Greiner A, Hellings P, Rotiroti G, Scadding G . Allergic rhinitis. Lancet. 2011; 378(9809):2112-22. DOI: 10.1016/S0140-6736(11)60130-X. View

19.

Norlander T, Linden M . Powered-assisted partial turbinectomy versus mometasone furoate nasal spray for relief of nasal blockage in chronic or idiopathic rhinosinusitis. Acta Otolaryngol. 2011; 131(12):1286-92. DOI: 10.3109/00016489.2011.615068. View

20.

Skoner D . Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol. 2001; 108(1 Suppl):S2-8. DOI: 10.1067/mai.2001.115569. View