Long-term effect of submucous turbinectomy in patients with perennial allergic rhinitis

Objectives. The long-term effect of submucous turbinectomy for patients with perennial allergic rhinitis was assessed. Study Design: A cohort study of 45 patients with severe perennial allergic rhinitis who underwent submucous turbinectomy and were followed up after surgery for more than 3 years was performed. We investigated quality of life in 30 of 45 patients who had passed over 5 years after the surgery. Methods. Nasal symptoms were assessed with a standard symptom score by diary cards. Nasal congestion was evaluated by rhinometry. Nasal challenge tests in vivo were performed to evaluate allergic reactions. These examinations were performed before surgery and at 1 year, more than 3 years, and more than 5 years after submucous turbinectomy. We determined the symptom scores and the quality of life using card questionnaires in 30 patients at the time point of more than 5 years after surgery. Results: The mean [+/-SD] total nasal symptom score (maximum 9) was significantly lower at 1 year after surgery (7.5+/-1.6 vs. 1.8+/-1.8, P<.0001) compared with before surgery. A significant improvement in nasal symptoms was noted at the 3-year (2.8±2.3, P<.0001) and 5-year (3.3+/-1.6, P<.0001) time points. A significant increase in total nasal airflow value was noted at each time point after surgery, with a gradual reduction in the total nasal symptom score as well (before surgery, 269.4±249.5 cm(3)/s; 1 y after surgery, 450.1±197.7 cm(3)/s; more than 3 y after surgery, 385.1±182.3 cm(3)/s). The nasal challenge test score was also reduced 1 year after surgery (2.1±1.0 vs. 0.6±0.7, P<.0001). However, there was no further significant increase at the 3-year time point (0.4+/-0.7, P<.0001) after surgery. In regard to postoperative quality of life, according to the results of the card questionnaire, 50% of the patients had not been receiving antiallergic treatments in the postoperative period. Conclusion. Our results suggest that submucous turbinectomy is a useful strategy for the long-term management of nasal allergic reaction and contributes to the improvement in quality of life.