From the Guidelines
Nasal turbinate surgery is not always permanent, and the turbinates can regrow or swell again if a patient continues to be exposed to allergens. The effectiveness of turbinate reduction procedures typically lasts between 1-3 years, though some patients experience longer-lasting results [ 1 ]. After surgery, the turbinate tissue may gradually enlarge again, especially if underlying allergies or irritants continue to affect the nasal passages.
Key Considerations
- To maintain surgical benefits, patients should follow a comprehensive allergy management plan including appropriate medications like intranasal corticosteroids (such as fluticasone, mometasone, or budesonide), antihistamines (like loratadine, cetirizine, or fexofenadine), and possibly immunotherapy for specific allergens.
- Environmental modifications are also crucial, including using air purifiers, frequent cleaning to reduce dust and allergens, and avoiding known triggers.
- The regrowth occurs because turbinate tissue naturally responds to inflammatory stimuli by swelling, and surgery doesn't eliminate this biological response mechanism [ 1 ].
- Even with the most aggressive surgical techniques, some functional turbinate tissue must remain to maintain normal nasal physiology, and this remaining tissue can still react to allergens [ 1 ].
Management Strategies
- Clinicians may offer, or refer to a surgeon who can offer, inferior turbinate reduction in patients with allergic rhinitis with nasal airway obstruction and enlarged inferior turbinates who have failed medical management [ 1 ].
- A comprehensive approach to managing allergies and reducing exposure to irritants is essential for maximizing the benefits of turbinate reduction surgery.
From the Research
Nasal Turbinate Surgery Outcomes
- The effectiveness of nasal turbinate surgery in relieving nasal obstruction can vary depending on several factors, including the presence of allergic rhinitis and ongoing exposure to allergens 2, 3.
- Studies have shown that inferior turbinate reduction surgery can provide significant relief from nasal obstruction, but the long-term durability of the outcome may be affected by the presence of allergic rhinitis 3, 4.
- In patients with perennial allergic rhinitis, combined treatment with allergen-specific immunotherapy and inferior turbinate reduction surgery may provide greater relief from nasal obstruction and improved nasal function compared to immunotherapy alone 4.
Recurrence of Nasal Obstruction
- The probability of substantial relief from nasal obstruction after septal and turbinate surgery may decrease over time, with some studies suggesting that the benefit of surgery may wane after 1-2 years 5.
- Patients with a clinical diagnosis of allergic rhinitis may be more likely to experience recurrent nasal obstruction after surgery, highlighting the importance of ongoing management and treatment of underlying allergies 3.
- The use of laser posterior nasal nerve ablation as a complementary tool to inferior turbinate reduction surgery may provide additional relief from nasal obstruction and congestion, with minimal complications reported 6.
Factors Influencing Surgical Outcomes
- The presence of allergic rhinitis and ongoing exposure to allergens can influence the outcome of nasal turbinate surgery, with some studies suggesting that allergy testing may not be a significant predictor of surgical success 3.
- The choice of surgical technique and the experience of the surgeon may also impact the outcome of nasal turbinate surgery, with studies highlighting the importance of judicious technique and a mucosal-sparing philosophy 2.