Inferior turbinate reduction for refractory pediatric allergic rhinitis: Symptom control and sleep-related quality of life outcomes

OBJECTIVE: To compare symptom control, sinonasal and sleep-related quality of life in children with refractory allergic rhinitis treated with inferior turbinate reduction versus medical therapy. DESIGN: This is a prospective cohort pilot study. POPULATION: Children aged 5-17 years with a documented allergic rhinitis refractory to 3 months of medical therapy, were recruited. The study group consisted of children who underwent surgery and the control group included children who remained on medical therapy. PRIMARY OUTCOMES: Three questionnaires pertaining to the sinus and nasal quality of life (SN-5), obstructive sleep apnea symptoms (OSA-18), and nasal obstruction symptom evaluation (NOSE) were collected before and after intervention at 1 and 3 months. Flexible endoscopic findings of disease regression before and after intervention were also mentioned. RESULTS: Thirty-four subjects were recruited, 17 of whom underwent surgery and 17 who received medical therapy. At 1 month follow-up, the mean drop in the questionnaires' scores (SN-5; OSA-18; NOSE) was greater in the study group (9.9 ± 5.8; 23.2 ± 9.8, 8.2 ± 3.8, respectively) compared to the control group (6.8 ± 3.9, 17.3 ± 7.1, 4.6 ± 2.8, respectively). The difference in symptoms improvement between the two groups was a statistically significant in all three questionnaires (p = 0.029; p = 0.037; p = 0.005; respectively). Similar results were obtained at 3 months follow-up. Almost all patients in the surgery group (88.2%) had complete disease regression in comparison to only 29.4% in the control group (p < 0.001). CONCLUSION: Introducing surgery to children with refractory allergic rhinitis can significantly improve the patient's symptoms and quality of life.