Blue laser inferior turbinate reduction for medically refractory chronic rhinitis: a retrospective analysis of clinical outcomes and optimal energy settings.

This study aims to evaluate the clinical efficacy of 445 nm blue laser inferior turbinate reduction (BITR) and establish optimal energy parameters for patients with chronic rhinitis (CR) refractory to pharmacotherapy. This was a retrospective cohort study of adult patients with medically refractory CR, a Nasal Obstruction Symptom Evaluation (NOSE) score ≥ 6, and a nasal congestion score ≥ 2. Turbinate hypertrophy was graded using the Camacho classification. Patients were stratified into Group A (Grade 3) and Group B (Grade 4). Primary endpoints were changes in NOSE scores and 12-hour Reflective Total Nasal Symptom Score (12-h rTNSS) at 1, 3, and 6 months. At 6 months, laser energy settings were analyzed in the top 50% of responders to determine optimal settings. Eighty-four patients were analyzed. At 6 months, NOSE scores improved by a mean of 91.1% in Group A and 88.0% in Group B (p < 0.001 for both). At 3 months, the 12-h rTNSS improved by 58.2% and 54.9%, respectively (p < 0.001 for both). In the top 50% of responders, the optimal mean energy delivered was 219 J (anterior) and 51 J (middle) for Group A, and 332 J (anterior) and 60 J (middle) for Group B. Postoperative complications were minimal. BITR is a safe and effective office-based procedure for medically refractory CR. To optimize outcomes, we recommend energy settings of approximately 219 J (anterior) and 51 J (middle) for moderate hypertrophy, and 332 J (anterior) and 60 J (middle) for severe hypertrophy.