Chemical cautery versus anterior inferior turbinectomy: Which is the better modality of treatment in nasal allergy?

Abstract

INTRODUCTION: Nasal allergy is one of the most common forms of allergy seen in practice. Although medical treatment is the most commonly accepted modality of treatment, surgery also has a role. This study was aimed at the assessment of nasal symptoms and mucociliary clearance in patients with nasal allergy, before and following chemical cautery with trichloroacetic acid (TCA) in one group and anterior–inferior turbinectomy in another group and to study advantages and disadvantages of each procedure. MATERIALS AND METHODS: This was a prospective, randomized, single-blind, controlled clinical trial conducted at a tertiary care hospital on a sample of fifty patients with a history of allergic rhinitis without a satisfactory response to medical line of treatment. Preoperative nasal airflow was assessed both subjectively and objectively using the nasal symptom score and the mucociliary clearance, respectively. One group was subjected to undergo anterior–inferior turbinectomy and the other group chemical cautery with 50% TCA. Postoperative nasal airflow was also assessed by similar methods after a duration of 1 month. RESULTS: All the patients had significant relief from their symptoms at the end of 1 month postprocedure, irrespective of the procedure done. However, patients who underwent anterior–inferior turbinectomy had more symptomatic relief compared to the other group. DISCUSSION: Debulking the inferior turbinate either with surgery or with cautery relives the nasal obstruction in patients with allergic rhinitis. The other symptoms of nasal allergy are also found to be less severe in these cases. CONCLUSION: Surgical line of treatment can be used as an effective intervention to satisfactorily alleviate patient's allergic symptoms. Anterior–inferior turbinectomy is preferred for the longer symptom-free life of the patients.