Allergic rhinitis improvement after septorhinoplasty in a sample of allergic rhinitis patients with septal deviation

a quasi-experimental study

Authors

Keywords:

Rhinitis, allergic, Quality of life, Rhinomanometry

Abstract

BACKGROUND: Allergic rhinitis (AR) is a chronic inflammatory disease that affects almost 30% of the adult population. OBJECTIVE: To describe and compare the evolution of symptoms in patients diagnosed with AR and septal deviation prior to and following septoplasty (STP). DESIGN AND SETTING: Quasi-experimental study developed in A Coruña University Hospital. METHODS: Patients aged 18-65 years who had been diagnosed with AR and septal deviation were recruited. Obstruction airflow was evaluated before and after surgery, by means of anterior rhinomanometry (RNM). Severity symptoms and quality of life were assessed using a visual analogue scale (VAS) and the ESPRINT questionnaire, respectively. RESULTS: A total of 50 subjects underwent STP and 42 were included in this study. Their mean age at the time of surgery was 34.16 ± 9.74 years (range 18-64). Significant reductions in mean VAS and ESPRINT were observed after surgery (P < 0.01). These outcomes were considered to represent an overall improvement in quality of life. The RNM results also improved significantly, from mean values of 478.07 ± 165.4 cm3/s before STP to 826.4 ± 175.5 cm3/s afterwards (P < 0.01). CONCLUSIONS: The negative correlations of VAS and ESPRINT with RNM, from before and to after STP, demonstrate the efficacy of scales and questionnaires as objective methods for determining obstruction in the absence of rhinomanometry. Patients with allergic rhinitis and septal deviation showed improvements in obstruction severity and medication use after STP.

Downloads

Download data is not yet available.

Author Biographies

Vanesa García Paz, Hospital Universitario A Coruña

MD. Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, A Coruña, Spain; Area Specialist Physician, Department of Allergology, Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain.

Cintia Micaela Chamorro Petronacci, Hospital Universitario A Coruña

PhD, DDS. Researcher, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Researcher Fellow, MedOralRes (Grupo de Investigación en Patología Oral Médico Quirúrgica), Universidad de Santiago de Compostela, A Coruña, Spain.

Roi Painceira Villar, Hospital Universitario A Coruña

DP, MSc, PhD. Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain.

Ricardo Becerro-de-Bengoa Vallejo, Hospital Universitario A Coruña

RN, BSc, MLIS, DPM, DHL, PhD. Full Professor, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.

Marta Elena Losa Iglesias, Hospital Universitario A Coruña

RN, DHL, BSc, MSc, PhD, DPM. Full Professor, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Spain.

Mario Pérez Sayáns, Hospital Universitario A Coruña

PhD, DDS. Researcher, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Research Fellow, MedOralRes (Grupo de Investigación en Patología Oral Médico Quirúrgica), Universidad de Santiago de Compostela, A Coruña, Spain.

Adolfo Sarandeses Garcia, Hospital Universitario A Coruña

PhD, MD. Professor, Otorhinolaryngology, Escuela Universitaria (EU), Universidade da Coruña, A Coruña, Spain. Supervision

Daniel López López, Hospital Universitario A Coruña

MSc, BSc, PhD, DPM. Senior Lecturer and Researcher, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain.

References

Licari A, Ciprandi G, Marseglia A, et al. Current recommendations and emerging options for the treatment of allergic rhinitis. Expert Rev Clin Immunol. 2014;10(10):1337-47. PMID: 25225773; https://doi.org/10.15 86/1744666X.2014.955476.

Chhabra N, Houser SM. Surgery for allergic rhinitis. Int Forum Allergy Rhinol. 2014;4 Suppl 2:S79-83. PMID: 25182362; https://doi.org/10.1002/alr.21387.

Eifan AO, Durham SR. Pathogenesis of rhinitis. Clin Exp Allergy. 2016;46(9):1139-51. PMID: 27434218; https://doi.org/10.1111/cea.12780.

Klimek L, Sperl A, Becker S, Mösges R, Tomazic PV. Current therapeutical strategies for allergic rhinitis. Expert Opin Pharmacother. 2019;20(1):83-9. PMID: 30439290; https://doi.org/10.1080/14656566.2018.1543401.

Vandenplas O, Vinnikov D, Blanc PD, et al. Impact of Rhinitis on Work Productivity: A Systematic Review. J Allergy Clin Immunol Pract. 2018;6(4):1274-86.e9. PMID: 29017832; https://doi.org/10.1016/j.jaip.2017.09.002.

Clark DW, Del Signore AG, Raithatha R, Senior BA. Nasal airway obstruction: Prevalence and anatomic contributors. Ear Nose Throat J. 2018;97(6):173-6. PMID: 30036414; https://doi.org/10.1177/014556131809700615.

Ma Q, Su K, Fu Z, Wang P, Shi H. Anxiety and depression in patients with nasal septal deviation. Am J Otolaryngol. 2020;41(3):102450. PMID: 32183991; https://doi.org/10.1016/j.amjoto.2020.102450.

Deveci I, Onder S, Surmeli M, et al. Impact of Nasal Septal Surgery on Sleep Quality and Attention-Deficit/Hyperactivity Disorder. J Craniofac Surg. 2018;29(7):e632-e635. PMID: 29608471; https://doi.org/10.1097/SCS.0000000000004541.

Bugten V, Nilsen AH, Thorstensen WM, Moxness MH, Amundsen MF, Nordgård S. Quality of life and symptoms before and after nasal septoplasty compared with healthy individuals. BMC Ear Nose Throat Disord. 2016;16:13. PMID: 27799847; https://doi.org/10.1186/s12901-016-0031-7.

Karatzanis AD, Fragiadakis G, Moshandrea J, et al. Septoplasty outcome in patients with and without allergic rhinitis. Rhinology. 2009;47(4):444-9. PMID: 19936374; https://doi.org/10.4193/Rhin08.126.

Kim YH, Kim BJ, Bang KH, Hwang Y, Jang TY. Septoplasty improves life quality related to allergy in patients with septal deviation and allergic rhinitis. Otolaryngol Head Neck Surg. 2011;145(6):910-4. PMID: 21965445; https://doi.org/10.1177/0194599811424119.

Seidman MD, Gurgel RK, Lin SY, et al. Clinical practice guideline: Allergic rhinitis. Otolaryngol Head Neck Surg. 2015;152(1 Suppl):S1-43. PMID: 25644617; https://doi.org/10.1177/0194599814561600.

Mullol J, Valero A, Alobid I, et al. Allergic Rhinitis and its Impact on Asthma update (ARIA 2008). The perspective from Spain. J Investig Allergol Clin Immunol. 2008;18(5):327-34. PMID: 18973095.

Zheng M, Wang X, Ge S, et al. Allergic and Non-Allergic Rhinitis Are Common in Obstructive Sleep Apnea but Not Associated With Disease Severity. J Clin Sleep Med. 2017;13(8):959-66. PMID: 28633721; https://doi.org/10.5664/jcsm.6694.

Magliulo G, Iannella G, Ciofalo A, et al. Nasal pathologies in patients with obstructive sleep apnoea. Acta Otorhinolaryngol Ital. 2019;39(4):250-6. PMID: 30933181; https://doi.org/10.14639/0392-100X-2173.

Muñoz-Cano R, Ribó P, Araujo G, et al. Severity of allergic rhinitis impacts sleep and anxiety: results from a large Spanish cohort. Clin Transl Allergy. 2018;8:23. PMID: 30002811; https://doi.org/10.1186/s13601-018-0212-0.

Gillman GS, Staltari GV, Chang YF, Mattos JL. A Prospective Study of Outcomes of Septoplasty with Turbinate Reductions in Patients with Allergic Rhinitis. Otolaryngol Head Neck Surg. 2019;160(6):1118-23. PMID: 30909804; https://doi.org/10.1177/0194599819838761.

Min HJ, Kim KS. Letter to the Editor Regarding “A Prospective Study of Outcomes of Septoplasty with Turbinate Reduction in Patients with Allergic Rhinitis”. Otolaryngol Head Neck Surg. 2020;162(5):780. PMID: 32354319; https://doi.org/10.1177/0194599820904650.

Wright L, Grunzweig KA, Totonchi A. Nasal Obstruction and Rhinoplasty: A Focused Literature Review. Aesthetic Plast Surg. 2020;44(5):1658-69. PMID: 32328743; https://doi.org/10.1007/s00266-020-01710-5.

Trimarchi M, Bellini C, Toma S, Bussi M. Back-and-forth endoscopic septoplasty: analysis of the technique and outcomes. Int Forum Allergy Rhinol. 2012;2(1):40-4. PMID: 22311840; https://doi.org/10.1002/alr.20100.

Mondina M, Marro M, Maurice S, Stoll D, de Gabory L. Assessment of nasal septoplasty using NOSE and RhinoQoL questionnaires. Eur Arch Otorhinolaryngol. 2012;269(10):2189-95. PMID: 22231798; https://doi.org/10.1007/s00405-011-1916-0.

Stewart MG, Witsell DL, Smith TL, et al. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg. 2004;130(2):157-63. PMID: 14990910; https://doi.org/10.1016/j.otohns.2003.09.016.

Faulcon P, Amanou L, Bonfils P. Le traitement de l’obstruction nasale par turbinectomie inférieure sub-totale dans les rhinites chroniques. Etude rétrospective à propos de 50 cas [Treatment of nasal obstruction with subtotal inferior turbinectomy in chronic rhinitis: a retrospective study on 50 patients]. Ann Otolaryngol Chir Cervicofac. 1998;115(4):228-33. PMID: 9827190.

Small P, Keith PK, Kim H. Allergic rhinitis. Allergy Asthma Clin Immunol. 2018;14(Suppl 2):51. PMID: 30263033; https://doi.org/10.1186/s13223-018-0280-7.

Canonica GW, Bousquet J, Mullol J, Scadding GK, Virchow JC. A survey of the burden of allergic rhinitis in Europe. Allergy. 2007;62 Suppl 85:17-25. PMID: 17927674; https://doi.org/10.1111/j.1398-9995.2007.01549.x.

Demoly P, Bousquet PJ, Mesbah K, Bousquet J, Devillier P. Visual analogue scale in patients treated for allergic rhinitis: an observational prospective study in primary care: asthma and rhinitis. Clin Exp Allergy. 2013;43(8):881-8. PMID: 23889242; https://doi.org/10.1111/cea.12121.

Lara-Sánchez H, Álvarez Nuño C, Gil-Carcedo Sañudo E, et al. Assessment of nasal obstruction with rhinomanometry and subjective scales and outcomes of surgical and medical treatment. Acta Otorrinolaringol Esp. 2017;68(3):145-50. PMID: 27780551; https://doi.org/10.1016/j.otorri.2016.06.007.

Haavisto LE, Sipilä JI. Acoustic rhinometry, rhinomanometry and visual analogue scale before and after septal surgery: a prospective 10-year follow-up. Clin Otolaryngol. 2013;38(1):23-9. PMID: 23122056; https://doi.org/10.1111/coa.12043.

Parthasarathi K, Christensen JM, Alvarado R, et al. Airflow and symptom outcomes between allergic and non-allergic rhinitis patients from turbinoplasty. Rhinology. 2017;55(4):332-8. PMID: 28888024; https://doi.org/10.4193/Rhin16.210.

Wallace DV, Dykewicz MS, Bernstein DI, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008;122(2 Suppl):S1-84. PMID: 18662584; https://doi.org/10.1016/j.jaci.2008.06.003. Erratum in: J Allergy Clin Immunol. 2008 Dec;122(6):1237.

Downloads

Published

2022-06-01

How to Cite

1.
Paz VG, Petronacci CMC, Villar RP, Vallejo RB- de-B, Iglesias MEL, Sayáns MP, Garcia AS, López DL. Allergic rhinitis improvement after septorhinoplasty in a sample of allergic rhinitis patients with septal deviation: a quasi-experimental study. Sao Paulo Med J [Internet]. 2022 Jun. 1 [cited 2025 Mar. 14];140(1):1-7. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/681

Issue

Section

Original Article