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. 2024 Jun;76(3):2626-2634.
doi: 10.1007/s12070-023-04404-x. Epub 2024 Mar 19.

Surgical Intervention in Allergic Rhinitis: Stuffy Versus Sneezy Runny Nose

D Jayapriya  1 , T C Vikram Raj Mohanam  1 , Mary Kurien  2 , Nishanth Savery  3 , Rajarajeswari Nalamate  2 , S Kalaiarasan  4 , Jishana Jamaldeen  3 , Sithananda Kumar Venkatesan  2 , V M Lakshana Deve  2
Affiliations

Surgical Intervention in Allergic Rhinitis: Stuffy Versus Sneezy Runny Nose

D Jayapriya et al. Indian J Otolaryngol Head Neck Surg. 2024 Jun.

Abstract

To detect proportion and surgical outcome of adult patients with allergic rhinitis non-responsive to medical treatment. To identify clinical candidacy for submucous turbinoplasty of inferior turbinate resection or soft tissue reduction. A prospective descriptive study of adults with clinical allergic rhinitis was done. Non-responders to medical therapy were identified and outcome of surgical intervention analyzed. There were 393 patients. Eighty-one patients (21%) were refractory to medical therapy. Presenting symptoms were sneezing with watery rhinorrhea among 72% and nasal obstruction in 28% patients All patients in the latter group had hypertrophied inferior turbinates with associated deviated nasal septum in 36.6%. Bony and mucosal inferior turbinate hypertrophy among 73.3% and mucosal hypertrophy among 26.7% were identified by a negative or positive response to on-table local vasoconstrictor application respectively. Submucosal inferior turbinoplasty with turbinate resection in the former and soft tissue reduction in the latter group were done, along with septoplasty among 36%. All patients revealed significant reduction in postoperative SNOT score. Crusting was more during early postoperative period among those with soft tissue reduction and simultaneous septoplasty, necessitating meticulous endoscopic follow-up. Adult allergic rhinitis presenting predominantly with nasal obstruction ('stuffy nose'), could be non-responsive to medical therapy unlike sneezy, runny nose, especially when obstructive symptoms are more than two years among older patients, suggesting presence of hypertrophied inferior turbinates. On-table response to vasoconstrictors is a reliable clinical indicator for submucous inferior turbinoplasty: negative and positive response suggesting turbinate resection among majority and soft tissue reduction among minority respectively.

Keywords: Allergic rhinitis; Hypertrophied inferior turbinates; Inferior Turbinate Resection or Soft tissue Reduction; Medical therapy non-responders.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
STROBE diagram for methodology
Fig. 2
Fig. 2
Distribution of duration of years with nasal obstruction. SD-standard devation
Fig. 3
Fig. 3
Distribution of type of submucous inferior turbinoplasty. IT-Inferior Turbinate
See this image and copyright information in PMC

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