Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0041-1726046
Inferior Turbinate Reduction during Rhinoplasty: Is There Any Effect on Rhinitis Symptoms?
Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.![](https://www.thieme-connect.de/media/10.1055-s-00025477/202201/lookinside/thumbnails/10-1055-s-0041-1726046_200263-1.jpg)
Abstract
Introduction Inferior turbinate surgery is often performed concomitantly with rhinoseptoplasty. As inferior turbinates play a major role in allergic rhinitis, it seems reasonable to suggest that inferior turbinate surgery reduces allergy.
Objective To assess the impact of nasal turbinate surgery on non-obstructive allergic symptoms (nasal discharge, sneezing, pruritus, and allergic conjunctivitis) and on the use of allergic medication in patients with allergic rhinitis undergoing rhinoseptoplasty.
Methods Secondary analysis of aggregated data from two randomized controlled trials. Participants with allergic rhinitis aged ≥ 16 years were recruited. Data from two groups were analyzed: patients with rhinoseptoplasty and concomitant turbinate reduction (intervention group) and patients with rhinoseptoplasty only (control group). The 90-day postoperative frequency of non-obstructive allergic symptoms and of nasal steroid and oral antihistamine use were analyzed.
Results A total of 100 patients were studied. The groups were similar in terms of allergic symptom intensity and mean age. The frequency of non-obstructive allergic symptoms decreased 90 days postoperative in both groups (p < 0.01). There was no difference between the groups in the frequency of non-obstructive allergic symptoms at 90 days (p = 0.835). Topical nasal steroid and oral histamine antagonist use decreased in the intervention group at 90 days (p < 0.05).
Conclusions Ninety days after the surgery, turbinate reduction performed in association with rhinoseptoplasty did not reduce the frequency of non-obstructive allergic symptoms more than rhinoplasty alone. However, the observed decrease in nasal steroid and oral antihistamine use suggests an impact of turbinate reduction on medication use in patients with allergic rhinitis undergoing rhinoseptoplasty.
Trial Registration ClinicalTrials.gov database (NCT01457638 and NCT02231216).
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the national research committee of our institution (Research Ethics Committee at Hospital de Clínicas de Porto Alegre (HCPA), number 20180109) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Data Availability
All relevant data are within the paper.
Publication History
Received: 10 August 2020
Accepted: 08 December 2020
Article published online:
05 August 2021
© 2021. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Leong SC, Eccles R. Inferior turbinate surgery and nasal airflow: evidence-based management. Curr Opin Otolaryngol Head Neck Surg 2010; 18 (01) 54-59 DOI: 10.1097/MOO.0b013e328334db14.
- 2 Veit JA, Nordmann M, Dietz B. et al. Three different turbinoplasty techniques combined with septoplasty: Prospective randomized trial. Laryngoscope 2017; 127 (02) 303-308 DOI: 10.1002/lary.26264.
- 3 Passàli D, Lauriello M, Anselmi M, Bellussi L. Treatment of hypertrophy of the inferior turbinate: long-term results in 382 patients randomly assigned to therapy. Ann Otol Rhinol Laryngol 1999; 108 (06) 569-575 DOI: 10.1177/000348949910800608.
- 4 Brożek JL, Bousquet J, Agache I. et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol 2017; 140 (04) 950-958 DOI: 10.1016/j.jaci.2017.03.050.
- 5 Passàli D, Passàli FM, Damiani V, Passàli GC, Bellussi L. Treatment of inferior turbinate hypertrophy: a randomized clinical trial. Ann Otol Rhinol Laryngol 2003; 112 (08) 683-688 DOI: 10.1177/000348940311200806.
- 6 Kim DH, Park HY, Kim HS. et al. Effect of septoplasty on inferior turbinate hypertrophy. Arch Otolaryngol Head Neck Surg 2008; 134 (04) 419-423 DOI: 10.1001/archotol.134.4.419.
- 7 Downs BW. The inferior turbinate in rhinoplasty. Facial Plast Surg Clin North Am 2017; 25 (02) 171-177 DOI: 10.1016/j.fsc.2016.12.003.
- 8 Grymer LF. Reduction rhinoplasty and nasal patency: change in the cross-sectional area of the nose evaluated by acoustic rhinometry. Laryngoscope 1995; 105 (4 Pt 1): 429-431 DOI: 10.1288/00005537-199504000-00017.
- 9 Lavinsky-Wolff M, Camargo Jr HL, Barone CR. et al. Effect of turbinate surgery in rhinoseptoplasty on quality-of-life and acoustic rhinometry outcomes: a randomized clinical trial. Laryngoscope 2013; 123 (01) 82-89 DOI: 10.1002/lary.23628.
- 10 de Moura BH, Migliavacca RO, Lima RK. et al. Partial inferior turbinectomy in rhinoseptoplasty has no effect in quality-of-life outcomes: A randomized clinical trial. Laryngoscope 2018; 128 (01) 57-63 DOI: 10.1002/lary.26831.
- 11 Grymer LF, Gregers-Petersen C, Baymler Pedersen H. Influence of lateral osteotomies in the dimensions of the nasal cavity. Laryngoscope 1999; 109 (06) 936-938 DOI: 10.1097/00005537-199906000-00018.
- 12 Grymer LF, Hilberg O, Pedersen OF, Rasmussen TR. Acoustic rhinometry: values from adults with subjective normal nasal patency. Rhinology 1991; 29 (01) 35-47
- 13 Lukka VK, Jacob TM, Jeyaseelan V, Rupa V. Do turbinate reduction procedures restore epithelial integrity in patients with turbinate hypertrophy secondary to allergic rhinitis? A histopathological study. Eur Arch Otorhinolaryngol 2018; 275 (06) 1457-1467 DOI: 10.1007/s00405-018-4955-y.
- 14 Brozek JL, Bousquet J, Baena-Cagnani CE. et al; Global Allergy and Asthma European Network, Grading of Recommendations Assessment, Development and Evaluation Working Group. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol 2010; 126 (03) 466-476 DOI: 10.1016/j.jaci.2010.06.047.
- 15 Bousquet J, Khaltaev N, Cruz AA. et al; World Health Organization, GA(2)LEN, AllerGen. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 (Suppl. 86) 8-160 DOI: 10.1111/j.1398-9995.2007.01620.x.
- 16 Mori S, Fujieda S, Igarashi M, Fan GK, Saito H. Submucous turbinectomy decreases not only nasal stiffness but also sneezing and rhinorrhea in patients with perennial allergic rhinitis. Clin Exp Allergy 1999; 29 (11) 1542-1548 DOI: 10.1046/j.1365-2222.1999.00645.x.
- 17 Chhabra N, Houser SM. The surgical management of allergic rhinitis. Otolaryngol Clin North Am 2011; 44 (03) 779-795, xi DOI: 10.1016/j.otc.2011.03.007.
- 18 Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 2004; 130 (02) 157-163 DOI: 10.1016/j.otohns.2003.09.016.
- 19 Chen YL, Tan CT, Huang HM. Long-term efficacy of microdebrider-assisted inferior turbinoplasty with lateralization for hypertrophic inferior turbinates in patients with perennial allergic rhinitis. Laryngoscope 2008; 118 (07) 1270-1274 DOI: 10.1097/MLG.0b013e31816d728e.
- 20 Bakshi SS, Shankar Manoharan K, Gopalakrishnan S. Comparison of the long term efficacy of radiofrequency ablation and surgical turbinoplasty in inferior turbinate hypertrophy: a randomized clinical study. Acta Otolaryngol 2017; 137 (08) 856-861 DOI: 10.1080/00016489.2017.1294764.
- 21 Huang TW, Cheng PW. Changes in nasal resistance and quality of life after endoscopic microdebrider-assisted inferior turbinoplasty in patients with perennial allergic rhinitis. Arch Otolaryngol Head Neck Surg 2006; 132 (09) 990-993 DOI: 10.1001/archotol.132.9.990.
- 22 Di Rienzo Businco L, Di Rienzo Businco A, Ventura L, Laurino S, Lauriello M. Turbinoplasty with quantic molecular resonance in the treatment of persistent moderate-severe allergic rhinitis: Comparative analysis of efficacy. Am J Rhinol Allergy 2014; 28 (02) 164-168 DOI: 10.2500/ajra.2014.28.3990.
- 23 Coste A, Dessi P, Serrano E. Empty nose syndrome. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129 (02) 93-97 DOI: 10.1016/j.anorl.2012.02.001.
- 24 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 (05) 865-869 DOI: 10.1097/00005537-200205000-00016.
- 25 Caffier PP, Scherer H, Neumann K, Lück S, Enzmann H, Haisch A. Diode laser treatment in therapy-resistant allergic rhinitis: impact on nasal obstruction and associated symptoms. Lasers Med Sci 2011; 26 (01) 57-67 DOI: 10.1007/s10103-010-0813-x.
- 26 Hamerschmidt R, Hamerschmidt R, Moreira AT, Tenório SB, Timi JRR. Comparison of turbinoplasty surgery efficacy in patients with and without allergic rhinitis. Rev Bras Otorrinolaringol (Engl Ed) 2016; 82 (02) 131-139 DOI: 10.1016/j.bjorl.2015.10.010.
- 27 Kim YH, Kim BJ, Bang KH, Hwang Y, Jang TY. Septoplasty improves life quality related to allergy in patients with septal deviation and allergic rhinitis. Otolaryngol Head Neck Surg 2011; 145 (06) 910-914 DOI: 10.1177/0194599811424119.
- 28 Baiardini I, Pasquali M, Giardini A. et al. Rhinasthma: a new specific QoL questionnaire for patients with rhinitis and asthma. Allergy 2003; 58 (04) 289-294 DOI: 10.1034/j.1398-9995.2003.00079.x.