EFFICACY OF TOPICAL NASAL STEROIDS AND TOTAL INFERIOR TURBINECTOMY IN HYPERTROPHIC RHINITIS

Abstract

Introduction: Nasal obstruction due to hypertrophied inferior turbinate is a problem commonly seen in ENT outpatient department. It is usually due to allergic phenomenon and wide spread use of nasal decongestants. Nasal obstruction forces the patients to adopt mouth breathing resulting in dryness of mouth, increased chance of throat infection, postnasal discharge and anosmia [1, 2]. Total inferior turbinectomy can be performed under local or general anesthesia in chronic nasal obstruction. It is safe and effective procedure to relieve nasal obstruction with low complication [3].
Apart from traditional methods like surgery and topical nasal steroids, newer methods like LASER reduction of inferior turbinate, immune modulation cryosurgery, turbinate cauterization and microdebrider are effective procedure to relieve nasal obstruction caused by inferior turbinate hypertrophy [4, 5]. Topical nasal decongestants can also cause rhinitis and nasal obstruction. Rhinitis medicamentosa results from rebound vasodilatation after prolonged use of nasal decongestants [6].
Objective: To compare the efficacy of topical nasal steroids therapy with total inferior turbinectomy in relieving nasal obstruction caused by inferior turbinate hypertrophy.
Study Design: Randomized Controlled Trials (RCT)
Setting: ENT department, Combined Military Hospital Rawalpindi.
Material and Methods: Sixty patients suffering from allergic rhinitis were divided in Two groups of thirty partients. Group A under went total inferior turbinectomy where as Group B advised Betamethasone nasal drops for two months. Relief in terms of nasal obstruction was assessed on Visual analogue scale two months after commencement of treatment. Chi-square test was applied as test of statistical significance to compare the two groups.
Results: Total inferior turbinectomy was found to be clinically superior to topical betamethasone drops in relieving nasal obstruction caused by inferior turbinate hypertrophy (p<0.001)
Conclusion: Total inferior turbinectomy is a better method of relieving obstruction as compared to topical betamethasone drops in nasal obstruction due to hypertrophied inferior turbinates