Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Jan 1;149(1):15-23.
doi: 10.1001/jamaoto.2022.3567.

Long-term Outcomes of Turbinate Surgery in Patients With Allergic Rhinitis: A Systematic Review and Meta-analysis

Sang Chul Park  1 , Do Hyun Kim  2 , Young Joon Jun  3 , Soo Whan Kim  2 , Hyeon-Jong Yang  4 , Song-I Yang  5 , Hyun Jung Kim  6 , Dong-Kyu Kim  7   8
Affiliations
Meta-Analysis

Long-term Outcomes of Turbinate Surgery in Patients With Allergic Rhinitis: A Systematic Review and Meta-analysis

Sang Chul Park et al. JAMA Otolaryngol Head Neck Surg. .

Abstract

Importance: Turbinate surgery is an effective treatment for allergic rhinitis (AR) refractory to medical treatment. However, the long-term outcomes of turbinate surgery are still unclear and have not yet been confirmed by a meta-analysis and systematic review of the literature.

Objective: To investigate the long-term outcomes and safety of turbinate surgery in AR by performing a meta-analysis.

Data sources: MEDLINE, Embase, the Cochrane Library, and ClinicalTrials.gov were searched through April 2021.

Study selection: Studies that analyzed turbinate surgery alone, had a follow-up period of more than 1 year, examined long-term efficacy of turbinate surgery, used current turbinate surgery methods, and were published in a peer-reviewed journal were included. Full-text reviews were performed by 2 independent reviewers. Conflicts were resolved by a third reviewer.

Data extraction and synthesis: Descriptive and quantitative data were extracted; weighted mean difference (WMD) was synthesized under a random-effects model. Heterogeneity was assessed using the Q statistic and the I2 metric. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines.

Main outcomes and measures: The long-term outcomes of turbinate surgery on subjective nasal symptoms and objective parameters.

Results: Of the 3962 citations retrieved, 18 studies comprising 1411 patients were included. Findings showed significantly decreased symptom scores in nasal obstruction (WMD, 4.60, 95% CI, 3.43-5.76), rhinorrhea (WMD, 3.12; 95% CI, 1.97-4.28), sneezing (WMD, 2.64; 95% CI, 1.74-3.54), itching (WMD, 1.75; 95% CI, 1.20-2.30), and nasal resistance (WMD, 0.16; 95% CI, 0.08-0.24) and a significant increased total nasal volume (WMD, 0.96; 95% CI, 0.73-1.19). There was no significant difference in the occurrence of any complication. More than 1 year after surgery, the improvements in nasal obstruction (WMD, 5.18; 95% CI, 3.00-7.37), rhinorrhea (WMD, 3.57; 95% CI, 1.78-5.37), and sneezing (WMD, 2.95; 95% CI, 1.58-4.32) were maintained.

Conclusions and relevance: In this systematic review and meta-analysis, turbinate surgery was associated with positive outcomes in AR and maintained the association during long-term follow-up. The rate of complications is also low. These findings can guide the preoperative counseling of patients with AR being considered for turbinate surgery.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.
Figure 1.. PRISMA Study Flow Diagram
PRISMA indicates Preferred Reporting Items for Systematic Reviews and Meta-analyses.
Figure 2.
Figure 2.. Forest Plots Comparing Nasal Symptoms Before and After Turbinate Surgery
Weights are from random-effects analysis. BRF indicates bipolar radiofrequency; MAIT, microdebrider-assisted inferior turbinoplasty; MAITL, MAIT with lateralization; MAST, multiple-antigen simultaneous test; RAIT, radiofrequency-assisted inferior turbinoplasty; SR, submucosal resection; TCRF, temperature-controlled radiofrequency; WMD, weighted mean difference.
Figure 3.
Figure 3.. Forest Plots Comparing Nasal Symptoms and Total Nasal Volume Before and After Turbinate Surgery by Postoperative Follow-up Period
WMD indicates weighted mean difference.
See this image and copyright information in PMC

References

    1. Bousquet J, Schünemann HJ, Togias A, et al. ; Allergic Rhinitis and Its Impact on Asthma Working Group . Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. J Allergy Clin Immunol. 2020;145(1):70-80.e3. doi: 10.1016/j.jaci.2019.06.049 - DOI - PubMed
    1. Wise SK, Lin SY, Toskala E, et al. International consensus statement on allergy and rhinology: allergic rhinitis. Int Forum Allergy Rhinol. 2018;8(2):108-352. doi: 10.1002/alr.22073 - DOI - PubMed
    1. Chhabra N, Houser SM. The surgical management of allergic rhinitis. Otolaryngol Clin North Am. 2011;44(3):779-795, xi. doi: 10.1016/j.otc.2011.03.007 - DOI - PubMed
    1. Chhabra N, Houser SM. Surgical options for the allergic rhinitis patient. Curr Opin Otolaryngol Head Neck Surg. 2012;20(3):199-204. doi: 10.1097/MOO.0b013e328352b821 - DOI - PubMed
    1. Willatt D. The evidence for reducing inferior turbinates. Rhinology. 2009;47(3):227-236. doi: 10.4193/Rhin09.017 - DOI - PubMed

Publication types