Comparison of turbinate volume reduction surgeries for nasal symptoms and surgery-related adverse effects in patients with chronic rhinitis: a systematic review and network meta-analysis

Abstract

PURPOSE: To assess the treatment outcomes of different turbinate volume reduction surgeries in patients with chronic rhinitis. METHODS: The treatment networks included six interventions—coblator-assisted turbinoplasty (CAT), laser ablation, microdebrider-assisted turbinoplasty (MAT), radiofrequency volumetric tissue reduction (RFVTR), submucosal diathermy (SMDiath), and partial inferior turbinectomy (PIT)—and a reference intervention (submucosal resection). Outcomes were changes in symptom scores, mucociliary transit time (MCT), and mean cross-sectional area (MCA) from baseline to post-treatment. Operation-related adverse event rates, including crust formation, synechia, mucosal tearing, and postoperative bleeding, were also assessed. Both pairwise and network meta-analyses were performed. RESULTS: MAT demonstrated strong performance in symptom reduction and MCA decrease; however, it ranked lower in MCT prolongation and was positioned mid to lower in the rankings for synechia, bleeding, and mucosal tearing. SMDiath was significantly less effective in relieving nasal obstruction at 12 months. RFVTR exhibited minimal disruption to mucociliary function. CAT and PIT showed intermediate outcomes across nasal symptoms, whereas laser ablation ranked lower in most domains except sneezing. RFVTR had the lowest incidence of mucosal tearing, and CAT, RFVTR, and SMDiath significantly reduced postoperative bleeding risk compared with reference intervention. In contrast, PIT were associated with higher bleeding risks. CONCLUSION: MAT offers superior efficacy with moderate-to-low adverse effect rankings. RFVTR demonstrated the greatest preservation of mucociliary function and the lowest incidence of mucosal tearing. CAT was linked to lower postoperative bleeding and synechia rates, whereas laser ablation and SMDiath had limited long-term benefits.

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