Di Ponio Anthony P, Samad Mohammad-Nadim, Pellizzari Richard, Mackie Hussein, Deeb Robert H, Craig John R
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, U.S.A.
Michigan State University College of Human Medicine, East Lansing, Michigan, U.S.A.
Laryngoscope. 2025 Mar;135(3):1015-1020. doi: 10.1002/lary.31839. Epub 2024 Oct 10.
Topical nasal decongestants (TNDs) are used to reduce nasal soft tissue edema and obstruction. However, after frequent TND use, patients can develop rhinitis medicamentosa (RM) with rebound nasal edema and obstruction. Management of RM has centered largely on TND cessation ± intranasal corticosteroids. The purpose of this study was to compare nasal obstruction outcomes following nasal obstruction surgery in patients with versus without RM.
A retrospective case-control study was conducted with adult patients who underwent bilateral inferior turbinate reduction (ITR) with or without septoplasty and nasal valve repair. Patients with versus without RM were assessed. RM was defined as at least daily TND use for ≥4 weeks. Preoperative and postoperative Nasal Obstruction Symptom Evaluation (NOSE) scores, and long-term TND cessation rates were collected. NOSE score changes were compared between patients with versus without RM.
Of the 36 RM patients, mean age was 52.0 years, and 63.9% were male. Of 116 non-RM patients, mean age was 41.6 years, and 46.6% were male. Postoperative NOSE scores were collected at a mean 972.1 days postoperatively for RM patients, and 565.0 days for non-RM patients. Mean NOSE score reductions were - 9.8 for RM and - 8.6 for non-RM patients, both of which were significant (p < 0.0001). NOSE score reductions were not significantly between the two groups (p = 0.2438). Long-term TND cessation was maintained in 86.1% of RM patients.
Patients with and without RM achieved similar long-term significant NOSE score reductions following nasal obstruction surgery, and 86.1% of RM patients maintained long-term TND cessation.
3 Laryngoscope, 135:1015-1020, 2025.
局部鼻减充血剂（TNDs）用于减轻鼻软组织水肿和鼻塞。然而，频繁使用TNDs后，患者可能会出现药物性鼻炎（RM），伴有鼻水肿和鼻塞反弹。RM的治疗主要集中在停用TNDs±鼻内使用皮质类固醇。本研究的目的是比较有和没有RM的患者在鼻阻塞手术后的鼻阻塞结局。
对接受双侧下鼻甲切除术（ITR）且有或无鼻中隔成形术和鼻瓣膜修复术的成年患者进行一项回顾性病例对照研究。评估有和没有RM的患者。RM定义为至少每日使用TNDs≥4周。收集术前和术后鼻阻塞症状评估（NOSE）评分以及长期停用TNDs的比率。比较有和没有RM的患者之间NOSE评分的变化。
36例RM患者的平均年龄为52.0岁，63.9%为男性。116例非RM患者的平均年龄为41.6岁，46.6%为男性。RM患者术后平均972.1天收集NOSE评分，非RM患者为565.0天。RM患者的平均NOSE评分降低了-9.8，非RM患者降低了-8.6，两者均有显著意义（p<0.0001）。两组之间NOSE评分降低无显著差异（p=0.2438）。86.1%的RM患者维持了长期停用TNDs。
有和没有RM的患者在鼻阻塞手术后均实现了相似的长期显著NOSE评分降低，且86.1%的RM患者维持了长期停用TNDs。
3《喉镜》，135:1015 - 1020，2025年。
