Chronic Rhinitis
REX MOULTON-MRRETT. MD, VICTOR PASSY, MD. DOROTHY HORLICK, MPH. CT MT. and
GEORGE RAUEL, MD, Irvine and Long Beach, California
DISCUSSION
The main finding of this pilot study is that ICIT led to early (less than 4 days) and sustained (at longest follow-up, including more than 18 months) improvement in nasal obstruction for the majority of patients (13 of 15 or 87%). ICIT did provide relief of nasal obstruction for all forms of medication-resistant NICR, including nasal obstruction induced by nasal continuous-positive airway pressure. Like IC of hemorrhoid tissue, ICIT was associated with minimal patient discomfort and few self-limiting complications (bloody nasal discharge and headache). Preliminary results from posterior rhinometry support the concept that ICIT causes a reduction in airway resistance within 3 weeks, which is sustained. A detailed description of the rhinometric data will be reported on completion of these analyses. 13
The spectral maximum of IC is similar to the neodymium-yttrium aluminum garnet laser but differs in requiring tissue contact for coagulation. Sparking does not occur, no electrical current is transferred to the patient, and no protective eye wear is required. These features allow usage with demand pacemakers, during pregnancy, near the eye, and in the face of high oxygen flow. Lack of surface adhesion with IC has been used for surgical hemostasis with liver injury, treatment of cervical lesions, genital condylomata, ablation of cutaneous Kaposi?s sarcoma, and depignientation of tattoos.?
We believe strongly that ICIT is an effective and safe method to reduce the head of the inferior turbinate. However, patients must be chosen carefully. ICIT will not help patients with nasal obstruction resulting from collapse of Cottle?s zones II or III. Our one treatment failure was most likely caused by a preexisting nasal valve collapse that had been missed. The one patient who reported a moderate improvement for 2 months only was subsequently found to have partial chaonal obstruction caused by ?mulberry? turbinates, reaffirming the conclusion.
