Patients with allergic rhinitis benefit from turbinate surgery: JAMA

KOREA: In allergic rhinitis, turbinate surgery was linked to successful outcomes that persisted over an extended period of time. According to a study published in JAMA Otolaryngology-Head & Neck Surgery, the rate of complications was also low.

When medical treatment for allergic rhinitis (AR) fails, turbinectomy surgery is an effective option. However, a meta-analysis and comprehensive assessment of the literature have not yet been able to establish the long-term effects of turbinate surgery.

The authors sought to conduct a meta-analysis to examine the long-term effects and safety of turbinate surgery in AR.

For this purpose, studies that focused solely on turbinate surgery, used current turbinate surgical techniques, had follow-up periods longer than a year, and were published in peer-reviewed journals were all included. 18 papers with 1411 patients were included from the 3962 citations found. Two independent reviewers conducted full-text analyses. A third reviewer was employed to resolve disagreements. In a random-effects model, weighted mean difference (WMD) was synthesized using retrieved descriptive and quantitative data. The I2 metric and the Q statistic were both used to evaluate heterogeneity. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting criteria were followed for conducting this study.

The major conclusions included the long-term effects of turbinate surgery on subjective nasal symptoms and objective measures.

Key findings:

• There were substantially lower symptom scores for 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).
• The total nasal volume was observed to have grown significantly (WMD, 0.96; 95% CI, 0.73-1.19).
• 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 sustained more than a year following surgery.
• The likelihood of any consequence occurring was not significantly different.

The authors came to the conclusion that patients with allergic rhinitis who had failed medicinal therapy had maintained therapeutic outcomes from turbinate surgery over a lengthy period of time.

These results, they continued, can direct preoperative counseling for AR patients who are being considered for turbinate surgery.

REFERENCE

Park SC, Kim DH, Jun YJ, et al. Long-term Outcomes of Turbinate Surgery in Patients With Allergic Rhinitis: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg. Published online November 17, 2022. doi:10.1001/jamaoto.2022.3567