{"title":"Chronic Rhinitis Surgery: Association Between Preoperative Severity and Response Rate.","authors":"Chien-Yu Huang, Jyun-Yi Liao, Bor-Hwang Kang, Yaoh-Shiang Lin, Jun-Wei Hsieh","doi":"10.1177/19458924241308990","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The success rate of chronic rhinitis surgery varies depending on the patients' factor and surgical method. While outcomes for nasal obstruction differ, the association between preoperative severity of other rhinitis symptoms, such as rhinorrhea, sneezing, and nasal itching, measured via the reflective total nasal symptom score (rTNSS) remains unevaluated.</p><p><strong>Objective: </strong>To evaluate the association between the response rate to surgical treatment of chronic rhinitis and preoperative severity.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among adult patients with chronic rhinitis symptoms refractory to medication and nasal spray for over 6 months and received radiofrequency ablation of inferior turbinates with posterior nasal nerve neurolysis. The primary endpoint was the change from baseline in 24-h rTNSS and nasal obstruction symptom evaluation (NOSE) scores. Postoperative surgery response rate, rTNSS score change, and score improvement ratios were also evaluated.</p><p><strong>Results: </strong>A total of 183 patients (110 males, 60.1%) were included in this study. After 3-month follow-up, the preoperative rTNSS was 6.51 ± 2.74 change to 1.70 ± 1.43, and the NOSE score was 56.48 ± 19.90 change to 4.56 ± 7.74. Both scores and all sub-scores showed significant differences when comparing preoperative, 1-month, and 3-month results (<i>P</i> < 0.05-0.001). The response rate by rTNSS for whole cohort was 78.14 ± 41.44% and 93.99 ± 23.83% at 1- and 3-month follow-up. Subgroup analyses were performed according to individual rTNSS scores and 2 in 1 score groups (ie, 1-2, 3-4, etc) and their relationship to the surgery outcomes. Both preoperative individual score and score groups were significantly associated with all post-operation outcomes (<i>P</i> = 0.022 to <0.001) in linear regression analysis.</p><p><strong>Conclusion: </strong>Patients with more severe preoperative rhinitis symptoms are associated with better response rate, post-operation symptom score changes, and score improvement ratio.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"109-117"},"PeriodicalIF":2.5000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Rhinology & Allergy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/19458924241308990","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/2 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The success rate of chronic rhinitis surgery varies depending on the patients' factor and surgical method. While outcomes for nasal obstruction differ, the association between preoperative severity of other rhinitis symptoms, such as rhinorrhea, sneezing, and nasal itching, measured via the reflective total nasal symptom score (rTNSS) remains unevaluated.
Objective: To evaluate the association between the response rate to surgical treatment of chronic rhinitis and preoperative severity.
Methods: A retrospective cohort study was conducted among adult patients with chronic rhinitis symptoms refractory to medication and nasal spray for over 6 months and received radiofrequency ablation of inferior turbinates with posterior nasal nerve neurolysis. The primary endpoint was the change from baseline in 24-h rTNSS and nasal obstruction symptom evaluation (NOSE) scores. Postoperative surgery response rate, rTNSS score change, and score improvement ratios were also evaluated.
Results: A total of 183 patients (110 males, 60.1%) were included in this study. After 3-month follow-up, the preoperative rTNSS was 6.51 ± 2.74 change to 1.70 ± 1.43, and the NOSE score was 56.48 ± 19.90 change to 4.56 ± 7.74. Both scores and all sub-scores showed significant differences when comparing preoperative, 1-month, and 3-month results (P < 0.05-0.001). The response rate by rTNSS for whole cohort was 78.14 ± 41.44% and 93.99 ± 23.83% at 1- and 3-month follow-up. Subgroup analyses were performed according to individual rTNSS scores and 2 in 1 score groups (ie, 1-2, 3-4, etc) and their relationship to the surgery outcomes. Both preoperative individual score and score groups were significantly associated with all post-operation outcomes (P = 0.022 to <0.001) in linear regression analysis.
Conclusion: Patients with more severe preoperative rhinitis symptoms are associated with better response rate, post-operation symptom score changes, and score improvement ratio.
背景：慢性鼻炎手术的成功率取决于患者的因素和手术方法。虽然鼻塞的结局不同，但术前其他鼻炎症状（如鼻漏、打喷嚏和鼻痒）严重程度之间的关联，通过反射性鼻症状总评分（rTNSS）测量，仍未得到评估。目的：探讨慢性鼻炎手术治疗有效率与术前严重程度的关系。方法：回顾性队列研究慢性鼻炎症状对药物和鼻喷雾剂难治6个月以上，接受射频消融下鼻甲并鼻后神经松解术的成年患者。主要终点是24小时rTNSS和鼻塞症状评估（NOSE）评分较基线的变化。评估术后手术有效率、rTNSS评分变化及评分改善率。结果：共纳入183例患者，其中男性110例，占60.1%。随访3个月后，术前rTNSS由6.51±2.74变为1.70±1.43，NOSE评分由56.48±19.90变为4.56±7.74。术前、术后1个月、术后3个月鼻炎评分及各分项评分差异均有统计学意义（P P = 0.022）。结论：术前鼻炎症状越严重患者的有效率、术后症状评分变化及评分改善率越高。
期刊介绍：
The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.
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