Rhinitis surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]
Overview
Surgery is not commonly required for the management of rhinitis. Surgical procedures are however sometimes indicated in the management of structural/mechanical problems, or coexisting comorbid conditions.[1]
Surgery
Surrgery in Allergic Rhinitis[2][3]
Surgical interventions in allergic rhinitis are usually indicated when there are structural conditions causing nasal obstruction, or associated co-morbid disorders that are not responsive to medical therapy. Surgical procedures that can be done include total inferior turbinectomy, radical turbinectomy, submucous turbinectomy, microdebrider turbinoplasty, cryosurgery, laser cautery, endoscopic sinus surgeries, etc. Some of the indications for surgical intervention in allergic rhinitis include:
- Hypertrophied inferior turbinate that is unresponsive to medical therapy
- Anatomic variations of the nasal septum with functional relevance
- Anatomic variations of the bony pyramid with functional/aesthetic relevance
- Chronic sinusitis, invasive fungal sinus disease
- A variety of nasal unilateral polyposis or therapy-resistant bilateral nasal polyps
- Adenoidal hypertrophy
Surgery in Nonallergic Rhinitis[4][5]
Surgical procedures such as posterior nasal nerve resection and vidian nerve neurectomy are occasionally used for the mamagement of some forms of nonallergic rhinitis such as gustatory and vasomotor rhinitis. These procedures are not usually recommended because of the complications that frequently arise, and they have also been shown to have short lasting results. However, with the advent of endoscopic sinus surgeries, better results are being achieved.
- Endoscopic vidian neurectomy: This is often effective in the surgical management of vasomotor rhinitis, and it is safe and well tolerated in most patients.
- Endoscopic posterior nasal neurectomy: There is scarce literature on the management of vasomotor rhinitis with endoscopic posterior nasal neurectomy.
References
- ↑ Sacre-Hazouri JA (2012). "[Chronic rhinosinusitis in children]". Rev Alerg Mex. 59 (1): 16–24. PMID 24007929.
- ↑ Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A; et al. (2008). "Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen)". Allergy. 63 Suppl 86: 8–160. doi:10.1111/j.1398-9995.2007.01620.x. PMID 18331513.
- ↑ Chhabra N, Houser SM (2011). "The surgical management of allergic rhinitis". Otolaryngol Clin North Am. 44 (3): 779–95, xi. doi:10.1016/j.otc.2011.03.007. PMID 21621061.
- ↑ Halderman A, Sindwani R (2015). "Surgical management of vasomotor rhinitis: a systematic review". Am J Rhinol Allergy. 29 (2): 128–34. doi:10.2500/ajra.2015.29.4141. PMID 25785754.
- ↑ Jovancevic L, Georgalas C, Savovic S, Janjevic D (2010). "Gustatory rhinitis". Rhinology. 48 (1): 7–10. doi:10.4193/Rhin07.153. PMID 20502728.