Sanjana Vijay NEMADE, Pratibha SAMPATE, Kiran SHINDE

Clinical efficacy of combined treatment with trichloroacetic acid chemical cautery and steroid spray in allergic rhinitis with inferior turbinate hypertrophy

Objectives: Comparison between efficacy of combined treatment with trichloroacetic acid TCA chemical cautery and steroid nasal spray in the treatment of allergic rhinitis AR with inferior turbinate hypertrophy ITH . Patients and Methods: A total of 132 patients with ITH due to AR were included in the study. Forty-four patients each were treated with TCA chemical cauterization of inferior turbinate Group A , steroid nasal spray Group B , or combined treatment with TCA cautery and steroid nasal spray Group C . The Symptom Severity Grade SSG 1-5 based on a validated Questionnaire Sheet QS as well as Visual Analog Scale were documented before and after treatment. Results: Before treatment, the SSG was 3-5 in 37 84% , 36 81.8% , and 40 90.9% patients in groups A, B, and C, respectively. At six months post-treatment, SSG 1-2 was achieved in 20 patients 45.4% in Group A, 18 patients 40.9% in group B and 31 patients 70.4% in Group C. Statistically significant improvement was found in patients who received the combined treatment. Conclusion: Combined treatment with TCA chemical cauterization of inferior turbinate and steroid nasal spray can be effective therapy for amelioration of symptoms of AR and ITH.

Keywords:

Inferior turbinate hypertrophy, questionnaire steroid nasal spray, symptom severity grade, trichloroacetic acid chemical cautery,

PDF

___

Harrow B, Sedaghat AR, Caldwell-Tarr A, Dufour R. A Comparison of Health Care Resource Utilization and Costs for Patients with Allergic Rhinitis on Single- Product or Free-Combination Therapy of Intranasal Steroids and Intranasal Antihistamines. J Manag Care Spec Pharm 2016;22:1426-36.
Aslam MJ, Aslam MA, Khan AS, Hussain A, Sharif A. Treatment of nasal obstruction due to hypertrophic inferior turbinates with application of silver nitrate solution. Ann Pak Inst Med Sci 2009;5:201-5.
Fernandes de Azevedo A, Martins DA, Cardoso CG, Candido de Moraes I, Pereira Michel LM, Rios Leite LH. Chemical cautery of the inferior turbinates with trichloroacetic acid. Int Arch Otorhinolaryngol 2011;15:475-7.
Badorrek P, Hohlfeld JM, Krug N, Joshi A, Raut A. Efficacy and safety of a novel nasal steroid, S0597, in patients with seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2015;115:325-9.e1.
Sözen E, Tansuker D, Yldrm Ö, Uçal YO, Coşkun BU. Effects of radiofrequency and intranasal steroid treatments on respiratory and olfactory functions in nasal obstruction. J Craniofac Surg 2013;24:e314-8.
Al-Anbaki F, Al-Sarhan H. Evaluation of treatment of sneezing and rhinorrhoea by local application of Trichloroacetic acid in patients with non infective rhinitis. Iraqi J Comm Med 2009;22:192-6.
Yao K, Sato K, Usui D, Kurihara R, Okamoto M, Iguchi Y, et al. Chemosurgery with trichloroacetic acid for allergic rhinitis: evaluation of the efficacy in terms of inhibition of Th2 cell infiltration. Auris Nasus Larynx 2009;36:292-9.
Bayram AA, Bayram Ö, Balıkcı HH, Özkül MH, Chatzi T, Karakas M et al. Long-term effects of fluticasone furoate assessed using peak nasal inspiratory flow in patients with non-allergic inferior turbinate hypertrophy. BAOJ Aller Immunol 2017;3:011.