Surgical Treatment Outcomes in the Management of Rhinitis: A Systematic Review and Meta-Analysis

Area of Science:

• Otolaryngology
• Rhinology
• Surgical Innovation

Background:

• Rhinitis presents with debilitating symptoms such as nasal obstruction, rhinorrhea, itching, and sneezing.
• Surgical options like inferior turbinate procedures and posterior nasal nerve (PNN) procedures aim to alleviate these symptoms.
• A comprehensive review is needed to quantify symptom resolution and guide clinical decisions.

Purpose of the Study:

• To systematically review and quantify the effectiveness of surgical interventions for rhinitis symptom relief.
• To compare the efficacy of different surgical procedures, including turbinate and PNN procedures.
• To provide evidence-based guidance for clinicians managing rhinitis.

Main Methods:

• A systematic literature search was conducted to identify relevant studies.
• Data on Total Nasal Symptom Score (TNSS) and Visual Analog Scale (VAS) for specific symptoms (rhinorrhea, obstruction, itching, sneezing) were extracted.
• Postnasal drip (PND) scores were also collected where available.

Main Results:

• Analysis of 20 studies (N=1408) showed a 50% reduction in TNSS across all surgical types.
• Nasal congestion, rhinorrhea, and PND experienced the most significant improvement (1.2-1.5 point reduction).
• PNN procedures demonstrated superior improvement in nasal itching and PND compared to turbinate surgeries, while overall congestion and rhinorrhea improvements were similar.

Conclusions:

• All surgical treatments for rhinitis effectively reduce symptom burden, particularly nasal congestion and rhinorrhea.
• Posterior nasal nerve (PNN) procedures offer enhanced benefits for nasal itching and postnasal drip.
• Surgical interventions provide significant relief for patients suffering from rhinitis symptoms.