Surgical procedures for nasal obstruction in Chronic Rhinitis

Nina Irawati
Allergy-Immunology Division ENT Depart.
Fac.of Medicine University of Indonesia
Ciptomangunkusumo Hospital, Jakarta
Abstract
Allergic rhinitis is a very common disorder that affects of patients annually and the
hallmark complaint of nasal obstruction significantly impacts the quality of life. Many
surgical options exist for the treatment of allergic rhinitis, directed primarily at the
underlying nasal obstructive component. Surgical management of allergic rhinitis has
traditionally been reserved for those cases refractory to medical management. The
increasing cost of medically managing perennial allergic rhinitis means that the surgical
management of this condition is gaining increasing prominence.
Surgical management of Allergic Rhinitis amelioration in years. Some of of this
technique can be performed under local anaesthesia in an office setting. There is no
doubt that surgical management of allergic rhinitis has a significant contribution to make
in the 15 to 20% of individuals whose symptoms cannot be controlled by maximal
medical management. The available surgical procedures is as follows : Outfracture of the
Inferior Turbinates, Sub Mucosal Diathermy of the Inferior Turbinates, Radiofrequency
Ablation ( unipolar or Bipolar whichcan be done under local anaesthesia), Laser
Reduction of Inferior Turbinates ( carbon dioxide or Argon lasers), Inferior Turbinoplasty
using Powered Instrumentation and Endoscopic Posterior Nasal Neurectomy alone or
combined with Submucosal Turbinectomy.
With
the evolution of these new surgical techniques, significant benefit in the effectiveness can
be shown in terms of overall cost of procedure versus cost of medication compliance,
potential side effects.
The purpose of this review is to highlight and discuss the various surgical modalities and
their historical efficacy.
Key words : Radiofrequency Ablation, Inferior Turbinoplasty using Powered
Instrumentation and Endoscopic Posterior Nasal Neurectomy alone or combined with
Submucosal Turbinectomy.