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Meta-Analysis
. 2023 Jan 1;149(1):15-23.
doi: 10.1001/jamaoto.2022.3567.

Long-term Outcomes of Turbinate Surgery in Patients With Allergic Rhinitis: A Systematic Review and Meta-analysis

Sang Chul Park  1 , Do Hyun Kim  2 , Young Joon Jun  3 , Soo Whan Kim  2 , Hyeon-Jong Yang  4 , Song-I Yang  5 , Hyun Jung Kim  6 , Dong-Kyu Kim  7   8
Affiliations
Meta-Analysis

Long-term Outcomes of Turbinate Surgery in Patients With Allergic Rhinitis: A Systematic Review and Meta-analysis

Sang Chul Park et al. JAMA Otolaryngol Head Neck Surg. .

Abstract

Importance: Turbinate surgery is an effective treatment for allergic rhinitis (AR) refractory to medical treatment. However, the long-term outcomes of turbinate surgery are still unclear and have not yet been confirmed by a meta-analysis and systematic review of the literature.

Objective: To investigate the long-term outcomes and safety of turbinate surgery in AR by performing a meta-analysis.

Data sources: MEDLINE, Embase, the Cochrane Library, and ClinicalTrials.gov were searched through April 2021.

Study selection: Studies that analyzed turbinate surgery alone, had a follow-up period of more than 1 year, examined long-term efficacy of turbinate surgery, used current turbinate surgery methods, and were published in a peer-reviewed journal were included. Full-text reviews were performed by 2 independent reviewers. Conflicts were resolved by a third reviewer.

Data extraction and synthesis: Descriptive and quantitative data were extracted; weighted mean difference (WMD) was synthesized under a random-effects model. Heterogeneity was assessed using the Q statistic and the I2 metric. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines.

Main outcomes and measures: The long-term outcomes of turbinate surgery on subjective nasal symptoms and objective parameters.

Results: Of the 3962 citations retrieved, 18 studies comprising 1411 patients were included. Findings showed significantly decreased symptom scores in 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) and a significant increased total nasal volume (WMD, 0.96; 95% CI, 0.73-1.19). There was no significant difference in the occurrence of any complication. More than 1 year after surgery, 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 maintained.

Conclusions and relevance: In this systematic review and meta-analysis, turbinate surgery was associated with positive outcomes in AR and maintained the association during long-term follow-up. The rate of complications is also low. These findings can guide the preoperative counseling of patients with AR being considered for turbinate surgery.

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Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.
Figure 1.. PRISMA Study Flow Diagram
PRISMA indicates Preferred Reporting Items for Systematic Reviews and Meta-analyses.
Figure 2.
Figure 2.. Forest Plots Comparing Nasal Symptoms Before and After Turbinate Surgery
Weights are from random-effects analysis. BRF indicates bipolar radiofrequency; MAIT, microdebrider-assisted inferior turbinoplasty; MAITL, MAIT with lateralization; MAST, multiple-antigen simultaneous test; RAIT, radiofrequency-assisted inferior turbinoplasty; SR, submucosal resection; TCRF, temperature-controlled radiofrequency; WMD, weighted mean difference.
Figure 3.
Figure 3.. Forest Plots Comparing Nasal Symptoms and Total Nasal Volume Before and After Turbinate Surgery by Postoperative Follow-up Period
WMD indicates weighted mean difference.
See this image and copyright information in PMC

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References

    1. Bousquet J, Schünemann HJ, Togias A, et al. ; Allergic Rhinitis and Its Impact on Asthma Working Group . Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. J Allergy Clin Immunol. 2020;145(1):70-80.e3. doi:10.1016/j.jaci.2019.06.049 - DOI - PubMed
    1. Wise SK, Lin SY, Toskala E, et al. . International consensus statement on allergy and rhinology: allergic rhinitis. Int Forum Allergy Rhinol. 2018;8(2):108-352. doi:10.1002/alr.22073 - DOI - PubMed
    1. Chhabra N, Houser SM. The surgical management of allergic rhinitis. Otolaryngol Clin North Am. 2011;44(3):779-795, xi. doi:10.1016/j.otc.2011.03.007 - DOI - PubMed
    1. Chhabra N, Houser SM. Surgical options for the allergic rhinitis patient. Curr Opin Otolaryngol Head Neck Surg. 2012;20(3):199-204. doi:10.1097/MOO.0b013e328352b821 - DOI - PubMed
    1. Willatt D. The evidence for reducing inferior turbinates. Rhinology. 2009;47(3):227-236. doi:10.4193/Rhin09.017 - DOI - PubMed

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