Treatment strategy for patients with vasomotor rhinitis following laser coagulation of nasal turbinates

Background: Laser coagulation of the nasal turbinates is a widely used procedure in the treatment of vasomotor rhinitis, with various wavelengths and techniques being employed. However, scientific sources on this subject rarely emphasizes postoperative nasal mucosa care. Authors either use various medications or limit postoperative care to nasal irrigation with saline solution. To date, no studies have been conducted comparing the effectiveness of different postoperative management methods following laser coagulation of the nasal turbinates. Aim: To conduct a comparative assessment of the effectiveness of two intranasal therapy regimens in the early postoperative period following laser coagulation of the inferior nasal turbinates. Methods: Superficial laser treatment was performed on the inferior nasal turbinates in 57 patients diagnosed with vasomotor rhinitis, using a 1.94 μm wavelength laser at 4 W power. During the seven-day postoperative period, patients were divided into two groups: Group 1 received irrigation therapy with isotonic saline, and Group 2 used a phenylephrine + cetirizine nasal spray. Symptom severity was assessed using the NOSE scale on postoperative day 1, day 7, and one month after surgery to evaluate symptom changes in two groups. Nasal endoscopy was also performed at the same time points. Results: On postoperative day 1, a 10-point worsening on the NOSE scale due to nasal obstruction was recorded in Group 1 (isotonic saline irrigation), whereas no deterioration on the NOSE scale was noted in Group 2 (phenylephrine + cetirizine spray). By day 7, the difference between the groups remained 10 points, reflecting a moderate level of dissatisfaction. After one month, when postoperative conservative therapy was discontinued, no significant differences between the groups were found, and all patients reported satisfactory nasal breathing. Conclusion: Local irrigation therapy, as well as phenylephrine combined with cetirizine in spray form, is justified during the postoperative period following laser coagulation of the inferior nasal turbinates.