gms | German Medical Science

Introduction: Rhinitis medicamentosa (RM) is defined as a condition of rebound nasal congestion induced by excessive or improper use of topical decongestants. The purpose of our study was to evaluate long-term outcomes of an outpatient-based diode laser inferior turbinate (IT) reduction (ITR) in therapy-refractory RM.

Methods: In a prospective clinical investigation, 40 consecutive RM patients underwent videoendoscopic ITR with a diode laser after topical anaesthetic preparation. Treatment efficiency was assessed by follow-ups 1 and 6 weeks as well as 6 and 12 months after surgery. Visual analogue scales (VAS; 0-10), rhinomanometry (RMM), IT photo documentation and the recurrent need for decongestants served for assessment of subjective and objective long-term clinical effectiveness.

Results: Preoperative addiction to decongestants lasted 5±2 years (mean±SD). There was no major bleeding requiring nasal packing, nor were there any other perioperative complications. Postoperative oedema disappeared within the first week, crusting within 6 weeks after surgery. VAS was characterized by very low values for intraoperative pain (0.4) and high postoperative patient satisfaction (7.4). After 6 months, nasal airflow data revealed a significant improvement of subjective VAS (2.9 to 7.2) and objective RMM (254 to 416 ccm/s inspiration at 150 Pa). A total of 88% of patients managed to successfully stop decongestant abuse after 6 months (73% after 1 year).

Conclusions: In therapy-refractory RM, outpatient diode laser ITR of hyperplastic IT represents a highly effective, safe, and well-tolerated treatment option that provides long-lasting improvement of nasal airflow and stopping addiction to nasal decongestants.