Underwater posterior nasal neurectomy compared to resection of peripheral branches of posterior nerve in severe allergic rhinitis

Abstract

Background

Several surgical procedures for posterior nasal neurectomy have been reported, but no conclusion has been reached about which procedure is best.

Objectives

The aim is to evaluate the improvement in symptom medication scores for resection of the posterior nasal nerve trunk in an underwater environment, with submucous inferior turbinectomy, without injuring the sphenopalatine artery (SPA) in severe allergic rhinitis.

Material and Methods

Improvements in symptom medication scores were retrospectively compared between 27 consecutive cases who underwent resection of the posterior nasal nerve trunk with turbinoplasty in an underwater environment without injuring the SPA (Underwater group) and, as a historical control, 16 consecutive cases who underwent resection of peripheral branches of the posterior nasal nerve with turbinoplasty (Control group).

Results

The improvements in symptom medication scores in the Underwater group were significantly better than in the Control group (3.07 vs. 1.96, p = 0.02).

Conclusions and significance

By using underwater posterior nasal neurectomy, we can easily and safely resect the posterior nasal nerve trunk under a clear surgical view without injuring the SPA. This technique with submucous inferior turbinectomy may, more than resection of peripheral branches of the posterior nasal nerve, be able to reduce the medication score and symptom medication score.

Chinese abstract

背景：已经有过几项鼻后神经切除外科手术的报道, 但还没有得出关于哪种手术是最好的结论。

目的：评估切除术中症状药物评分的改善情况。在不伤害蝶腭动脉（SPA）的情况下, 对严重过敏性鼻炎患者, 通过粘膜下下鼻甲成形术进行水下环境中的后鼻神经干切除。

材料和方法：回顾性比较连续 27病例和对照组的症状药物评分的改善。这些病人在水下环境中接受鼻后神经干切除术和鼻甲成形术而不损伤 SPA（水下组）, 而作为历史性对照的连续 16 例病人接受鼻神经后部周围分支切除术与鼻甲成形术（对照组）。

结果：水下组症状药物评分改善显著优于对照组（3.07 相对于 1.96, p ¼ 0.02）。

结论与意义：通过水下鼻后神经切除术, 我们可以在清晰的手术视野下轻易且安全地切除鼻后神经干, 而不会损伤 SPA。这种粘膜下下鼻甲切割术, 可能比切除鼻后神经周围分支, 降低更多的药物评分和症状药物评分。

Keywords:

• Posterior nasal neurectomy
• underwater
• allergic rhinitis
• endoscopic surgery
• submucous inferior turbinectomy

Disclosure statement

The authors have no conflict of interest to declare.