Postoperative autologous mononuclear cell therapy in pediatric hypertrophic rhinitis: comparative clinical outcomes following laser diode and bipolar cauterization

Abstract

Introduction. Hypertrophic chronic rhinitis in children is frequently associated with inferior turbinate enlargement, leading to persistent nasal obstruction, sleep disturbances, and reduced quality of life. Surgical reduction techniques such as laser diode and bipolar cauterization are widely used; however, postoperative inflammation and delayed mucosal recovery remain clinical challenges. Cell-based regenerative approaches may enhance tissue repair and functional restoration. The aim of this study was to evaluate the efficacy and safety of postoperative autologous mononuclear cell therapy in children undergoing inferior turbinate reduction. Materials and methods. A prospective comparative study included 40 children aged 7–17 years diagnosed with hypertrophic chronic rhinitis. Patients were allocated into four parallel groups (n=10 each): laser diode (LD), laser diode plus cell therapy (LD+CT), bipolar cauterization (CB), and bipolar cauterization plus cell therapy (CB+CT). Autologous mononuclear cells were obtained from peripheral blood and administered locally in the early postoperative period under endoscopic guidance. Patients were followed for 24 months. Primary outcomes included symptom severity (NOSE score), rhinomanometric nasal resistance, and endoscopic evaluation of edema and crusting. Secondary outcomes included acoustic rhinometry parameters, complications, and recurrence rate. Statistical analysis involved repeated-measures models and intergroup comparisons with p<0.05 considered significant. Results. All groups demonstrated postoperative improvement; however, patients receiving adjunctive cell therapy showed significantly greater and sustained symptom reduction. At 24 months, mean NOSE scores decreased from 73 to 14 in the LD+CT group compared with 30 in LD alone and 36 in CB. Rhinomanometric resistance showed greater reduction in LD+CT (0.45 to 0.20 Pa/cm³/s) compared to non-cell therapy groups. Postoperative inflammatory signs and recurrence rates were lower in both cell therapy groups, with the most favorable outcomes observed in the laser diode plus cell therapy combination. Conclusions. Postoperative autologous mononuclear cell therapy enhances mucosal recovery, reduces inflammation, and improves long-term functional outcomes in pediatric hypertrophic rhinitis. The combination of laser diode surgery and cell therapy demonstrated the best clinical profile over 24 months, supporting further development of regenerative strategies in rhinologic surgery.