From the Guidelines
Boggy nasal turbinates should be treated with intranasal corticosteroids as the first line of treatment, as recommended by the 2015 clinical practice guideline for allergic rhinitis 1. This condition is typically caused by allergic rhinitis, vasomotor rhinitis, or chronic sinusitis.
- Treatment options include:
- Intranasal corticosteroids like fluticasone (Flonase) or mometasone (Nasonex), used as 1-2 sprays in each nostril daily for symptom control.
- Oral antihistamines such as loratadine (10mg daily) or cetirizine (10mg daily) can help reduce allergic symptoms.
- Nasal saline irrigation with a neti pot or saline spray can provide immediate relief by moisturizing the nasal passages and removing irritants.
- Decongestants like oxymetazoline nasal spray may offer short-term relief but should not be used for more than 3 consecutive days to avoid rebound congestion.
- Environmental modifications are also important, such as keeping windows closed during high pollen seasons, using air purifiers, and regularly washing bedding in hot water to reduce allergen exposure.
- If symptoms persist despite these measures, consultation with an allergist or ENT specialist is recommended for possible allergen testing or evaluation for structural abnormalities that might require surgical intervention, including inferior turbinate reduction 1. The goal of treatment is to reduce the size of the inferior turbinate and alleviate nasal obstruction, as described in the 2008 practice parameter for the diagnosis and management of rhinitis 1.
From the Research
Boggy Nasal Turbinates
Boggy nasal turbinates can be a symptom of various conditions, including allergic rhinitis and vasomotor rhinitis.
- The treatment of boggy nasal turbinates often involves the use of nasal sprays, such as fluticasone propionate, which has been shown to be effective in reducing nasal obstruction and turbinate hypertrophy 2.
- Allergic rhinitis is a common condition that can cause boggy nasal turbinates, and its management includes allergen avoidance, pharmacotherapy, and immunotherapy 3.
- Nasal sprays, including steroidal, saline, decongestant, antihistamine, and anticholinergic preparations, are commonly used to treat sinonasal disease, including boggy nasal turbinates 4.
Treatment Options
- Fluticasone propionate is a widely used intranasal corticosteroid that has been shown to be effective in reducing nasal symptom scores in patients with allergic rhinitis 3, 5.
- Combination therapy with intranasal azelastine and fluticasone propionate has been shown to be superior to monotherapy in reducing total nasal symptom scores in patients with allergic rhinitis 5.
- Concomitant use of corticosteroid nasal spray and antihistamine (oral or local spray) has been shown to be effective in the symptomatic management of allergic rhinitis, with combination therapy being superior to either therapy given alone or placebo 6.
Efficacy of Treatment
- Fluticasone propionate has been shown to provide significant relief from nasal obstruction and turbinate hypertrophy in patients with vasomotor rhinitis 2.
- Combination therapy with intranasal azelastine and fluticasone propionate has been shown to be superior to monotherapy in reducing total nasal symptom scores in patients with allergic rhinitis, with a mean change from baseline of -2.41 5.
- Concomitant use of corticosteroid nasal spray and antihistamine (oral or local spray) has been shown to be effective in reducing total nasal symptom scores in patients with allergic rhinitis, with a weighted mean difference of -1.16 compared to solo intranasal corticosteroid 6.