Modified posterior nasal nerve neurectomy with inferior turbinoplasty, as a treatment for intractable rhinitis syndrome: a long-term effect prospective cohort study

Ahmed S. El Sayed Eid Saleh, Department of OtoRhinoLaryngology, Banha University, Banha
Hossam M. Kamal Aly Rabie, Department of OtoRhinoLaryngology, Ain Shams University, Cairo, Egypt
Tarek A.H. Hamdy, Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Ain Shams University, 6 M, 1224 Square, Sheraton Heliopolis, Cairo, EgyptFollow

Article Type

Original Study

Subject Area

Rhinology, Endoscopic sinus surgery

Abstract

Background Allergic and vasomotor rhinitis are a well-known medical entities affecting a huge population. In most cases, medical therapy helps these people. However, sometimes these treatments are often ineffective. The surgical treatment of intractable rhinitis had been introduced a long time ago, starting from vidian nerve neurectomy to a recently introduced more simple and safe procedure [endoscopic posterior nasal nerve (PNN) neurectomy]. This study combined two valid and widely used surgical procedures for intractable rhinitis surgical management, that is, modified PNN neurectomy and inferior turbinoplasty (IT), aiming to ensure long-term results. Patients and methods A total of 30 adult patients were enrolled for this prospective study, during the period between January 2018 and May 2021, in the age group between 21 and 50 years of both sexes, diagnosed with chronic intractable rhinitis with failed medical therapy. All patients underwent a simple computed tomogram of the nose and paranasal sinuses before and after surgery as well as a diagnostic nasal endoscopy. Patients were evaluated using the Okuda system and the rhinoconjunctivitis quality-of-life questionnaire. Endoscopic microdebrider IT and selective PNN neurectomy with tragal cartilage interface were applied to all patients. Results The overall rhinitis symptom score sheet was significantly improved after the procedure, and also, Lund–Kennedy endoscopic score significantly changed from the first month following surgery, and the airway space significantly improved. The QOL of the patients was highly and significantly improved, and it was still stable and valid for the next 18 months after the operation. Conclusion Our modified posterior nasal neurectomy combined with IT procedure was an effective, long-term lasting, and safe method to treat intractable postnasal discharge syndrome.

Keywords

inferior turbinoplasty, intractable rhinitis, posterior nasal neurectomy

Recommended Citation

Saleh A, Rabie H, Hamdy T, et al. Modified posterior nasal nerve neurectomy with inferior turbinoplasty, as a treatment for intractable rhinitis syndrome: a long-term effect prospective cohort study. Pan Arab J. Rhinol. 2022; 12 : 79-86.
Available at: https://pajr.researchcommons.org/journal/vol12/iss2/9 DOI: https://doi.org/10.58595/2090-7559.1212