Is posterior nasal neurectomy the definitive treatment for intractable allergic rhinitis: A prospective study

Abstract

Objectives: Allergic rhinitis (AR) has a significant effect on the quality of life and accounts for unproductive times at work and school, causes disturbed sleep patterns and can lead to daytime somnolence. It is fairly prevalent in the world with medical management still being the mainstay of treatment. Patients suffer for a significant number of years before they undergo surgical management for their intractable rhinitis. Thus, this prospective observational study was conducted to reinforce the proficiency of posterior nasal neurectomy in being an effective method for ending this suffering.

Methods: Thirty patients with troublesome intractable rhinitis underwent posterior nasal neurectomy. Pre- and postoperative Visual Analogue Scale (VAS) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores were compared to study the improvement in nasal and ocular symptoms. Each domain of these scores was studied separately.

Results: The mean reduction in the VAS was from 6.76 ± 0.884 preoperatively to a mean of 5.33 ± 0.675 at 1 month, 3.81 ± 0.462 at 3 months and 2.53 ± 0.405 at 6 months postoperatively. The mean RQLQ score was reduced from preoperative 4.22 ± 1.091 to a mean of 3.82 ± 1.072 at 1 month, 3.55 ± 1.063 at 3 months and 3.18 ± 1.173 at 6 months postoperatively. Thus, a statistically significant improvement was seen in both mean VAS and RQLQ scores (P < 0.001), and also when each domain was compared separately.

Conclusion: Endoscopic posterior nasal neurectomy may be an effective way of improving symptoms in patients with intractable AR and freeing them from long-term medical regimes, thereby improving their quality of life.

Keywords: endoscopic posterior nasal neurectomy; intractable allergic rhinitis; posterior nasal nerve; vidian neurectomy.