Changes in clinical and functional parameters in patients with vasomotor rhinitis during coblation inferior turbinate reduction combined with physical therapy

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Abstract

BACKGROUND: Vasomotor rhinitis (VR) is one of the most common otorhinolaryngological disorders. Its pronounced clinical manifestations, such as nasal obstruction, cause not only physical discomfort but also psycho-emotional disturbances and social maladaptation, substantially reducing quality of life. The most effective modern treatment for VR is cold plasma surgery (coblation), which destroys the vascular network of the inferior nasal turbinate. The combined use of low-intensity laser therapy (LILT) and transcranial electrical stimulation (TES), which have a pronounced pathogenetic effect, is a promising rehabilitation technology for patients with VR after surgery.

AIM: This study aimed to evaluate the clinical efficacy of combined LILT and TES in the postoperative period following cold plasma surgery in patients with VR.

METHODS: A prospective, randomized, controlled, comparative study was conducted in 137 patients with VR who were randomly assigned to four groups. Group 1 (control, n = 34) received basic therapy (BT) alone. Group 2 (comparison 1, n = 35) underwent a course of LILT in addition to BT. Group 3 (comparison 2, n= 34) received TES in addition to BT. Group 4 (main group, n = 34) received both LILT and TES alongside BT. The efficacy of physical therapy in the postoperative period was assessed by changes in complaints, reactive inflammation, anterior active rhinomanometry parameters, and SNOT-22 score.

RESULTS: Additional physical therapy reduced the incidence of complaints in patients with VR, with the greatest improvement observed in the main group. Changes in objective parameters corroborated the changes in subjective VR symptoms. The combined use of LILT and TES resulted in the greatest improvement in anterior active rhinomanometry parameters and mucociliary transport time. Physical therapy had a positive effect on reactive postoperative inflammation of the nasal mucosa, with the greatest improvement achieved in the main group.

CONCLUSIONS: The adjunctive use of LILT and TES accelerates the regression of clinical signs of VR and improves objective functional parameters of the nasal mucosa in the postoperative period. Combination physical therapy results in a significant reduction in clinical signs and a maximum improvement in quality of life.

About the authors

Svetlana A. Belkina

Clinical Hospital No. 1, Moscow

Email: doctor_belkina@mail.ru
ORCID iD: 0009-0000-9498-6031
Russian Federation, Moscow

Tatiana G. Pelishenko

Clinical Hospital No. 1, Moscow

Email: doctor217@mail.ru
ORCID iD: 0000-0001-6597-2167
SPIN-code: 4176-8850

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Sergey N. Nagornev

Russian Scientific Center of Surgery named after academician B.V. Petrovsky

Author for correspondence.
Email: drnag@mail.ru
ORCID iD: 0000-0002-1190-1440
SPIN-code: 2099-3854

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

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