Surgical Management of Allergic Rhinitis

Authors

  • Daniel J. Lee, MD, FRCSC St. Michael’s Hospital and Division of Rhinology, Department of Otolaryngology – Head & Neck Surgery, University of Toronto, Toronto, ON
  • Yvonne Chan, MD, FRCSC, MSc, HBSc St. Michael’s Hospital and Division of Rhinology, Department of Otolaryngology – Head & Neck Surgery, University of Toronto, Toronto, ON

DOI:

https://doi.org/10.58931/cait.2024.4162

Abstract

The inferior turbinate is composed of a central bony structure surrounded by ciliated pseudostratified columnar epithelium. Underneath the epithelium, there are mucous glands, goblet cells and venous sinusoids in the submucosa, The inferior turbinate is supplied by the inferior turbinate branch of the posterior lateral nasal artery from the sphenopalatine artery. The inferior turbinates humidify the air, trap particles and direct airflow throughout the nasal cavity. Due to these functions, the inferior turbinates are often the first point of contact for allergens in the inspired air. With immune responses prompted by a cascade of inflammatory mediators such as immunoglobulin E, mast cells, histamine, and leukotrienes, mucous glands become stimulated and the vasculature within the inferior turbinate engorges. This results in inferior turbinate hypertrophy, leading to increased nasal discharge and nasal obstruction. For individuals refractory to medical therapy for nasal obstruction, surgical inferior turbinate reduction techniques can be employed to help alleviate the symptoms. For those with rhinorrhea refractory to medical therapy, surgical management aimed at reducing parasympathetic innervation to the nasal cavity to reduce nasal discharge production can be also option. 

Author Biographies

Daniel J. Lee, MD, FRCSC, St. Michael’s Hospital and Division of Rhinology, Department of Otolaryngology – Head & Neck Surgery, University of Toronto, Toronto, ON

Dr. Daniel Lee is a rhinologist in the Division of Rhinology, Department of Otolaryngology–Head & Neck Surgery at the University of Toronto. He finished his medical school and residency at the University of Toronto and completed a rhinology and anterior skull base fellowship at the University of Pennsylvania. His clinical interests include advanced rhinology and skull base surgery. His research interests include application of artificial intelligence and the relevant clinical outcomes in rhinology. 

Yvonne Chan, MD, FRCSC, MSc, HBSc, St. Michael’s Hospital and Division of Rhinology, Department of Otolaryngology – Head & Neck Surgery, University of Toronto, Toronto, ON

Dr. Yvonne Chan is an Associate Professor, the Vice Chair of Education and Continuing Professional Development Director in the Department of Otolaryngology-Head & Neck Surgery at the University of Toronto. She is the Otolaryngologist-in-chief at St. Michael’s Hospital. She completed 2 rhinology fellowships, one with Dr. Fred Kuhn and the other with Professors PJ Wormald and Alkis Psaltis. She has been the co-editor of the Otolaryngology textbook, K. J. Lee’s Essential Otolaryngology now in its 12th edition since 2015. Other texts that she has co-edited include: Rhinology and Allergy: Clinical Reference Guide and Essential Paths to Life After Residency. 

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Published

2024-06-19

How to Cite

1.
Lee DJ, Chan Y. Surgical Management of Allergic Rhinitis. Can Allergy Immunol Today [Internet]. 2024 Jun. 19 [cited 2024 Dec. 3];4(1):6—9. Available from: https://canadianallergyandimmunologytoday.com/article/view/4-1-lee-et-all

Issue

Volume 4, Issue 1, Spring 2024

Section

Articles