{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:23:31Z","timestamp":1791491011073,"version":"4.3.4"},"reference-count":54,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T00:00:00Z","timestamp":1693267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Allergic rhinitis (AR) is a common condition that is frequently associated with atopic inferior turbinate hypertrophy (ITH) resulting in nasal obstruction. Current guidelines support the use of subcutaneous allergen immunotherapy (SCIT) when patients fail pharmacologic management. However, there is a lack of consensus regarding the role of inferior turbinate reduction (ITR), a treatment that we hypothesize is cost\u2010effective compared with other available treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cost\u2010effectiveness analysis comparing the following treatment combinations over a 5\u2010year time horizon for AR patients presenting with atopic nasal obstruction who fail initial pharmacotherapy: (1) continued pharmacotherapy alone, (2) allergy testing and SCIT, (3) allergy testing and SCIT and then ITR for SCIT nonresponders, and (4) ITR and then allergy testing and SCIT for ITR nonresponders. Results were reported as incremental cost\u2010effectiveness ratios (ICERs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For patients who fail initial pharmacotherapy, prioritizing ITR, either by microdebrider\u2010assisting submucous resection or radiofrequency ablation, before SCIT was the most cost\u2010effective strategy. Probabilistic sensitivity analysis demonstrated that prioritizing ITR before SCIT was the most cost\u2010effective option in 95.4% of scenarios. ITR remained cost\u2010effective even with the addition of concurrent septoplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For many AR patients who present with nasal obstruction secondary to atopic inferior turbinate hypertrophy that is persistent despite pharmacotherapy, ITR is a cost\u2010effective treatment that should be considered prior to immunotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA \u2013 Laryngoscope, 2023 <jats:italic>Laryngoscope<\/jats:italic>, 134:1572\u20131580, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31003","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T12:37:22Z","timestamp":1693312642000},"page":"1572-1580","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Cost\u2010effectiveness Analysis of Inferior Turbinate Reduction and Immunotherapy in Allergic Rhinitis"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7774-5786","authenticated-orcid":false,"given":"Michael","family":"Yong","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaishan","family":"Aravinthan","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology \u2013 Head and Neck Surgery University of British Columbia Faculty of Medicine  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keshinisuthan","family":"Kirubalingam","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Thamboo","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology \u2013 Head and Neck Surgery University of British Columbia Faculty of Medicine  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Nadeau","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Harvard T.H. 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