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Treatment of Severe Pregnancy Rhinitis Using Microdebrider-Assisted Inferior Turbinoplasty: A Case Report

심한 임신성 비염 환자에서 미세분쇄기를 이용한 하비갑개 수술: 증례보고

  • Shin, Dan Bi (Department of Otolaryngology-Head and Neck Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Jung On (Department of Otolaryngology-Head and Neck Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Chun, Tae-Uk (Department of Otolaryngology-Head and Neck Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Tae-Hoon (Department of Otolaryngology-Head and Neck Surgery, Ulsan University Hospital, University of Ulsan College of Medicine)
  • 신단비 (울산대학교 의과대학 울산대학교병원 이비인후과학교실) ;
  • 이정온 (울산대학교 의과대학 울산대학교병원 이비인후과학교실) ;
  • 천태욱 (울산대학교 의과대학 울산대학교병원 이비인후과학교실) ;
  • 이태훈 (울산대학교 의과대학 울산대학교병원 이비인후과학교실)
  • Received : 2017.06.05
  • Accepted : 2018.03.26
  • Published : 2018.11.30

Abstract

Pregnancy rhinitis is a relatively common condition. It is characterized by the presence of nasal symptoms, especially nasal congestion, not present prior to pregnancy, but typically present during the last 6 or more weeks of pregnancy, without other signs of respiratory tract infection or any known allergic causes, and disappearing completely within 2 weeks after delivery. Nasal saline irrigation, intranasal steroid spray, and oral antihistamines are usually recommended as the first line of treatment for rhinitis. However, most pregnant women refuse medical treatment for pregnancy rhinitis because of the fear of teratogenicity. Severe pregnancy rhinitis increases the risk of snoring, which has been suggested as having adverse effects on the fetus. In cases where the patients are unable to control their symptoms, pregnancy rhinitis can negatively affect the quality of life (QOL) as well as the pregnancy outcome. Therefore, special caution is required for determining the appropriate diagnosis and treatment modalities for pregnancy rhinitis. Here, we report for the first time, the successful treatment of pregnancy rhinitis that was unresponsive to conservative management and medical therapy by using microdebrider-assisted inferior turbinoplasty at the final stages of pregnancy, along with a review of the relevant literature.

Keywords

References

  1. Ellegard EK. The etiology and management of pregnancy rhinitis. Am J Respir Med 2003;2:469-75. https://doi.org/10.1007/BF03256674
  2. Kumar R, Hayhurst KL, Robson AK. Ear, nose, and throat manifestations during pregnancy. Otolaryngol Head Neck Surg 2011;145:188-98. https://doi.org/10.1177/0194599811407572
  3. Ellegard EK. Clinical and pathogenetic characteristics of pregnancy rhinitis. Clin Rev Allergy Immunol 2004;26:149-59. https://doi.org/10.1385/CRIAI:26:3:149
  4. Vlastarakos PV, Manolopoulos L, Ferekidis E, Antsaklis A, Nikolopoulos TP. Treating common problems of the nose and throat in pregnancy: what is safe?. Eur Arch Otorhinolaryngol 2008;265:499-508. https://doi.org/10.1007/s00405-008-0601-4
  5. Settipane RA. Other causes of rhinitis: mixed rhinitis, rhinitis medicamentosa, hormonal rhinitis, rhinitis of the elderly, and gustatory rhinitis. Immunol Allergy Clin North Am 2011;31:457-67. https://doi.org/10.1016/j.iac.2011.05.011
  6. Gilbey P, McGruthers L, Morency AM, Shrim A. Rhinosinusitis-related quality of life during pregnancy. Am J Rhinol Allergy 2012;26:283-6. https://doi.org/10.2500/ajra.2012.26.3776
  7. Orban N, Maughan E, Bleach N. Pregnancy-induced rhinitis. Rhinology 2013;51:111-9. https://doi.org/10.4193/Rhin12.045
  8. Goldstein G, Govindaraj S. Rhinologic issue in pregnancy. Allergy Rhinol (Providence) 2012;3:e13-5. https://doi.org/10.2500/ar.2012.3.0028
  9. Choi JH, Jun YJ, Oh JI, Jung JY, Hwang GH, Yum GH, et al. Impact of open-mouth breathing on upper airway anatomy in patients with sleep-disordered breathing. J Rhinol 2012;19:55-9.
  10. Lee SK, Kim SW, Lee YC, Kim SH, Eun YG, Cho JS. Difference of polysomnographic, anthropometric, physical and radiologic findings in an obstructive sleep apnea syndrome patient with excessive daytime sleepiness. J Rhinol 2008;15:55-61.
  11. Ellegard EK. Special consideration in the treatment of pregnancy rhinitis. Womens Health (Lond) 2005;1:105-14. https://doi.org/10.1517/17455057.1.1.105
  12. Romano A, Orabona GD, Salzano G, Abbate V, Iaconetta G, Califano L. Comparative study between partial inferior turbinotomy and microdebrider-assisted inferior turbinoplasty. J Craniofac Surg 2015;26:e235-8. https://doi.org/10.1097/SCS.0000000000001500
  13. Yau WP, Mitchell AA, Lin KJ, Werler MM, Hernandez-Diaz S. Use of decongestants during pregnancy and the risk of birth defects. Am J Epidemiol 2013;178:198-208. https://doi.org/10.1093/aje/kws427
  14. Rocklin RE. Asthma, asthma medications and their effects on maternal/fetal outcomes during pregnancy. Reprod Toxicol 2011;32:189-97. https://doi.org/10.1016/j.reprotox.2011.05.023
  15. Incaudo GA, Takach P. The diagnosis and treatment of allergic rhinitis during pregnancy and lactation. Immunol Allergy Clin North Am 2006;26:137-54. https://doi.org/10.1016/j.iac.2005.10.005
  16. Nagpal G, Rathmell JP. Managing pain during pregnancy and lactation. In: Benzon HT, Rathmell JP, Wu CL, Turk DC, Argoff CE, editors. Practical management of pain. 5th ed. Philadelphia: Mosby; 2014. p.474-91.
  17. Ye T, Zhou B. Update on surgical management of adult inferior turbinate hypertrophy. Curr Opin Otolaryngol Head Neck Surg 2015;23:29-33.

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