Turbinate surgery: which rhinitis are most at risk.

Area of Science:

• Otorhinolaryngology
• Allergology
• Immunology

Background:

• Allergic rhinitis (AR) and non-allergic rhinitis (NAR) are distinct conditions causing nasal hyper-reactivity.
• These conditions, termed overlapped rhinitis (ORs), can coexist in 15-20% of patients, leading to persistent symptoms and misdiagnosis.
• Turbinate surgery is often pursued when medical treatments for rhinitis fail.

Purpose of the Study:

• To identify rhinitis types most frequently associated with turbinate surgery.
• To determine the prevalence of overlapped rhinitis (ORs) in patients undergoing turbinate surgery.
• To evaluate the contribution of non-allergic rhinitis components to treatment failure.

Main Methods:

• A study involving 120 patients undergoing turbinate surgery for hypertrophy.
• Preoperative assessments included anterior rhinoscopy, nasal endoscopy, nasal cytology, and allergy testing (skin prick tests and/or specific IgE serum assays).

Main Results:

• 75% of patients had AR, and 25% had NAR; only 8% had purely allergic rhinitis.
• Non-allergic rhinitis with eosinophils and mast cells (NARESMA) was the most common superimposed rhinitis (62.5%).
• NARESMA overlapping AR significantly increased the risk of undergoing turbinate surgery.

Conclusions:

• Patients undergoing turbinate surgery often have complex rhinitis forms, with the non-allergic component frequently causing treatment failure.
• Accurate diagnosis of rhino-allergic conditions is crucial for effective treatment.
• Integrating allergy tests and nasal cytology into clinical practice is essential for proper patient management.