The suitability of performing laser inferior turbinectomy under local anaesthesia in an out-patient setting was assessed, regarding its effectiveness and patients' toleration of the procedure. Prospective data collection was undertaken from 129 patients undergoing laser inferior turbinectomy over four years. Patients were assessed, pre-operatively, operatively and at two weeks and three months post-operatively, for pain, complications and symptoms, using the sino-nasal assessment questionnaire. All patients had hypertrophied inferior turbinates. Ninety-eight patients complained of nasal obstruction and 67 had the procedure as part of treatment for snoring. One hundred and twenty-one of the patients had treatment to both inferior turbinates. There were no cases of intra-operative haemorrhage. The average pre-operative sino-nasal assessment questionnaire score was 18.22, which improved to 10.68 at the three month post-operative assessment (p<0.001). Five patients had significant intra-operative pain. This study shows that laser inferior turbinectomy under local anaesthesia is well tolerated and that good results can be achieved when performing the procedure in the out-patient department.

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The real world effectiveness and adverse event profile of intranasal steroid sprays is similar in clinical practice to that seen in trials. The number needed to treat to obtain symptomatic benefit is 1.26 and to reduce all symptoms is 4. The number needed to harm is 11. Intranasal steroids are an effective and safe first line treatment for rhinitis.

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