Surgery for allergic rhinitis

Allergic rhinitis, commonly known as hay fever, affects millions of individuals worldwide, causing bothersome symptoms such as nasal congestion, sneezing, itching, and runny nose. While medications and allergen avoidance strategies are often effective in managing mild to moderate cases, some individuals may experience persistent symptoms despite conservative treatments. In such cases, surgical intervention may be considered as an alternative or adjunctive treatment approach.

Leading consultant ENT and rhinoplasty surgeon Mr Ali Qureishi explores surgical treatment options for allergic rhinitis, including their indications, procedures, and potential benefits.

Woman with allergic rhinitis.

Turbinate reduction

The turbinates are bony structures located within the nasal passages that help humidify and filter the air we breathe. In individuals with allergic rhinitis, the turbinates can become swollen and inflamed, contributing to nasal congestion and obstruction. Turbinate reduction procedures aim to reduce the size of the turbinates to improve:

nasal airflow and;
alleviate symptoms.

Who is suitable for this procedure?

Turbinate reduction may be recommended for individuals who experience chronic nasal congestion and obstruction due to allergic rhinitis that doesn’t respond adequately to medications or other conservative treatments.

What’s involved in the procedure for turbinate reduction?

Turbinate reduction can be performed using various techniques, including radiofrequency ablation, submucosal resection, or turbinate outfracture. These procedures are typically performed under local or general anesthesia and may be done in an outpatient setting.

What are the benefits of turbinate reduction?

By reducing the size of the turbinates, these procedures can improve nasal airflow, reduce nasal congestion, and alleviate symptoms of allergic rhinitis, leading to improved quality of life for affected individuals.

Septoplasty

Septoplasty is a surgical procedure performed to correct a deviated nasal septum, which is a common anatomical abnormality that can contribute to nasal congestion and obstruction. While not specifically indicated for allergic rhinitis, septoplasty may be considered in individuals with both allergic rhinitis and a deviated septum to improve nasal airflow and symptom control.

What qualifies someone for the septoplasty procedure?

Septoplasty may be recommended for individuals with a deviated nasal septum who experience chronic nasal congestion, obstruction, or difficulty breathing through the nose, particularly if conservative treatments have been ineffective.

What’s involved in a septoplasty procedure?

During septoplasty, the surgeon makes incisions inside the nose to access the nasal septum. The deviated portion of the septum is then straightened or removed, and the nasal passages are reshaped to improve airflow. Septoplasty is typically performed under general anaesthesia and may be done on an outpatient basis.

What are the benefits of a septoplasty?

By correcting a deviated nasal septum, septoplasty can improve nasal airflow, reduce nasal congestion, and enhance the effectiveness of other treatments for allergic rhinitis, such as medication therapy and allergen avoidance measures.

Endoscopic sinus surgery

Endoscopic sinus surgery is a minimally invasive procedure performed to treat chronic sinusitis, a condition characterized by inflammation of the sinus cavities. While not a primary treatment for allergic rhinitis, endoscopic sinus surgery may be considered in individuals with severe, uncontrolled allergic rhinitis that’s complicated by chronic sinus infections or nasal polyps.

What are the indications that someone requires endoscopic sinus surgery?

Endoscopic sinus surgery may be recommended for individuals with chronic sinusitis and allergic rhinitis who don’t respond adequately to medications or other conservative treatments, or those who have complications such as nasal polyps or recurrent sinus infections.

What happens in the procedure for endoscopic sinus surgery?

During endoscopic sinus surgery, the surgeon uses a thin, flexible tube with a camera (endoscope) to visualise the sinus cavities. Instruments are then inserted through the nostrils to remove diseased tissue, open blocked sinus passages, and improve drainage. Endoscopic sinus surgery is typically performed under general anaesthesia and may require a short hospital stay.

What are the advantages of this operation?

By improving sinus drainage and reducing inflammation, endoscopic sinus surgery can alleviate symptoms of chronic sinusitis and improve nasal airflow in individuals with allergic rhinitis, leading to better symptom control and quality of life.

Is surgical treatment the only treatment option for allergic rhinitis?

In conclusion, surgical treatment options may be considered for individuals with allergic rhinitis who experience persistent symptoms despite conservative treatments. Turbinate reduction, septoplasty and endoscopic sinus surgery are among the surgical procedures available to improve nasal airflow, reduce congestion, and alleviate symptoms associated with allergic rhinitis. However, the decision to undergo surgery should be made in consultation with a qualified healthcare provider based on individual needs, symptoms, and treatment goals.

If you’re thinking about a long-term solution to allergic rhinitis, arrange a consultation with Dr Qureishi via his Top Doctors profile.