Efficacy of posterior nasal neurectomy for allergic rhinitis combined with chronic rhinosinusitis with nasal polyps.

Abstract

Background: Allergic rhinitis combined with chronic rhinosinusitis with nasal polyps (ARwCRSwNP) is very common clinically. Conventionally, the treatment for these patients is surgical method for CRSwNP followed by treatment with a nasal steroid spray or other antiallergic drugs to control AR. In recent years, some rhinologists introduced vidian neurectomy (VN) or posterior nasal neurectomy (PNN) into endoscopy to treat refractory AR and reported an encouraging outcome. Furthermore, we explore the control of recurrence of nasal polyps and improvement in symptoms after endoscopic PNN for the treatment of ARwCRSwNP. Objective: To investigate the control of recurrence of nasal polyps and improvement in symptoms after endoscopic PNN for the treatment of ARwCRSwNP. Methods: Eighty-five patients with ARwCRSwNP who were admitted to our hospital from November 2016 to July 2018 were enrolled in two groups. Group A underwent conventional functional endoscopic sinusitis surgery (FESS) combined with PNN; group B underwent conventional FESS alone. VAS, RQLQ, SNOT-22 and postoperative nasal endoscopy were used to evaluate the improvement in symptoms and the recurrence of nasal polyps. Results: The experimental group had better control of sneezing (p < .05) and rhinorrhea (p < .01) than the control group. For those who underwent surgery more than 6 months prior in both groups, the recurrence rate was 29.6% (8/27) in the experimental group and 44.4% (8/18) in the control group, and there was no significant difference (χ2 = .483, p = .487). Conclusion: FESS combined with PNN can improve the symptoms of sneezing and rhinorrhea caused by ARwCRSwNP more obviously than FESS alone, but there is no clear statistical advantage of this procedure for improving the overall symptoms and controlling the recurrence of nasal polyps.

• Authors: Song Li, Jinzhang Cheng, Jingpu Yang, Yin Zhao, Zhiling Zhu, Chang Zhao, Zonggui Wang
• Journal: Acta oto-laryngologica (Acta Otolaryngol) Vol. 139 Issue 10 Pg. 890-894 (Oct 2019) ISSN: 1651-2251 [Electronic] England
• PMID: 31452425 (Publication Type: Journal Article, Randomized Controlled Trial)

Topics

• Adult
• Chronic Disease
• Denervation
• Endoscopy
• Female
• Humans
• Male
• Middle Aged
• Nasal Polyps (complications, surgery)
• Paranasal Sinuses (innervation)
• Rhinitis, Allergic (complications, surgery)
• Sinusitis (complications, surgery)
• Treatment Outcome