Chronic Rhinitis Surgery: Association Between Preoperative Severity and Response Rate

The success rate of chronic rhinitis surgery varies depending on the patients' factor and surgical method. While outcomes for nasal obstruction differ, the association between preoperative severity of other rhinitis symptoms, such as rhinorrhea, sneezing, and nasal itching, measured via the reflective total nasal symptom score (rTNSS) remains unevaluated.

To evaluate the association between the response rate to surgical treatment of chronic rhinitis and preoperative severity.

A retrospective cohort study was conducted among adult patients with chronic rhinitis symptoms refractory to medication and nasal spray for over 6 months and received radiofrequency ablation of inferior turbinates with posterior nasal nerve neurolysis. The primary endpoint was the change from baseline in 24-h rTNSS and nasal obstruction symptom evaluation (NOSE) scores. Postoperative surgery response rate, rTNSS score change, and score improvement ratios were also evaluated.

A total of 183 patients (110 males, 60.1%) were included in this study. After 3-month follow-up, the preoperative rTNSS was 6.51 ± 2.74 change to 1.70 ± 1.43, and the NOSE score was 56.48 ± 19.90 change to 4.56 ± 7.74. Both scores and all sub-scores showed significant differences when comparing preoperative, 1-month, and 3-month results (P < 0.05-0.001). The response rate by rTNSS for whole cohort was 78.14 ± 41.44% and 93.99 ± 23.83% at 1- and 3-month follow-up. Subgroup analyses were performed according to individual rTNSS scores and 2 in 1 score groups (ie, 1-2, 3-4, etc) and their relationship to the surgery outcomes. Both preoperative individual score and score groups were significantly associated with all post-operation outcomes (P = 0.022 to <0.001) in linear regression analysis.

Patients with more severe preoperative rhinitis symptoms are associated with better response rate, post-operation symptom score changes, and score improvement ratio.