The effect of early radiofrequency turbinate reduction, intranasal steroid, and antihistamine H-1 on persistent allergic rhinitis: a randomized clinical trial

•Radiofrequency turbinate reduction gives more clinical improvement in persistent allergic rhinitis.•Radiofrequency turbinate reduction reduces pathological remodeling marker (MMP-9/TIMP-1 ratio).•Radiofrequency turbinate reduction might be suggested as one of the adjuvant therapies for moderate-sev...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Brazilian journal of otorhinolaryngology 2023-03, Vol.89 (2), p.235-243
Hauptverfasser: Irawati, Nina, Bashiruddin, Jenny, Rengganis, Iris, Lisnawati, Lisnawati, Dharma, Rahayuningsih, Harahap, Alida, Wardhani, Retno S.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:•Radiofrequency turbinate reduction gives more clinical improvement in persistent allergic rhinitis.•Radiofrequency turbinate reduction reduces pathological remodeling marker (MMP-9/TIMP-1 ratio).•Radiofrequency turbinate reduction might be suggested as one of the adjuvant therapies for moderate-severe persistent AR. We aimed to evaluate the effect of radiofrequency turbinate reduction as an initial treatment on clinical improvement, inflammatory mediators, and remodeling process. Between July 2018–February 2020, 32 patients with moderate-severe persistent AR were randomly divided into 2 groups. Intervention group received radiofrequency turbinate reduction followed by intranasal steroid and Antihistamine H-1 (AH-1), control group received intranasal steroid and AH-1. Both groups were evaluated for clinical improvement (using visual analogue scale based on total nasal symptoms score, peak nasal inspiratory flow, and turbinate size using imageJ) after 4 and 8 weeks of treatment. Inflammatory mediators (ELISA from nasal secretions was performed to measure ECP, IL-5, and HSP-70) and remodeling markers (nasal biopsy followed by immunohistochemistry examination was performed to evaluate MMP-9, TIMP-1, and PAI-1) were evaluated in week 4. Three patients dropped out of the study, resulting in 16 patients in intervention group and 13 patients in control group. At week 4, clinical response improved significantly in the intervention group compared to control group (Chi-Square test, p  0.05). Reduction in the ratio of MMP-9/TIMP-1 were significantly higher in intervention group (unpaired t-test, p  0.05). Early radiofrequency turbinate reduction followed by pharmacotherapy given to persistent moderate-severe AR patients give more improvement only in early clinical symptoms and reduce MMP-9/TIMP-1 ratio, thus it might be suggested as one of the adjuvant therapies for the management of moderate-severe persistent AR. However, further investigation with a larger sample size and longer follow-up period is needed. 1B.
ISSN:1808-8694
1808-8686
1808-8686
DOI:10.1016/j.bjorl.2022.04.001