Comparison between Inferior Turbinate Reduction Surgery and Continued Medical Treatment in Refractory Allergic Rhinitis Patients with Nasal Obstruction

BACKGROUND Allergic rhinitis is a widely spread disease that results from an IgE-mediated hypersensitivity reaction of the nasal mucosa to inhaled allergens. It is predominantly treated by allergen avoidance and medical treatment, but when these methods fail to control symptoms then surgery to the inferior turbinate of nose is performed. Objectives of the study were to assess the effectiveness of inferior turbinate surgery on unrelieved or partially relieved nasal obstruction in patients after maximal continued medical management of proven allergic rhinitis, compare the results using different surgical techniques and measure short and long-term results. METHODS This prospective study enrolled patients who had undergone inferior turbinoplasty. All patients were grouped and tested for obstruction of nose, running nose, excessive sneezing, alteration of smell, change in voice due to nasal obstruction, snoring history, and itching of nose. The last follow up of all patients was done at 90 days after surgery. the study was conducted in a tertiary referral center of Mysuru, among 90 patients with refractory allergic rhinitis who had substantial mucosal hypertrophy of the inferior turbinates. 45 patients had undergone inferior turbinate reduction surgeries and 45 patients were on continued medical treatment with follow-up on 7, 30, and 90 days after surgery. RESULTS In this study the age of patients ranged from 18 to 50 years. 71 % patients improved significantly. On comparison there was improvement in the condition of patient over time in all groups considering the symptom score. Statistically significant difference in improvement was noted within groups over a period of time, that is before treatment to 7, 30, 90 days after treatment. Whereas on comparing symptoms score between groups, no statistically significant association was found. However, the group which underwent submucous resection has comparatively better results, followed by group with continued medical treatment, group which underwent turbinectomy, and lastly group which underwent out fracturing of inferior turbinates. CONCLUSIONS Our results suggest that inferior turbinate reduction surgeries are effective for decreasing total nasal resistance and improving quality of life in patients with refractory allergic rhinitis who have inferior turbinate hypertrophy with nasal obstruction and all other symptoms.