Therapeutic Effects Of Vadian Neurectomy On Vasomotor Rhinitis And A Preliminary Study Of Its Possible Mechanism

Objective:To investigate the therapeutic effect of vadianneurectomy on the vasomotor rhinitisMethod:Vadian neurectomy under nasal endoscope was carried out on 45 patients with vasomotor, and "Rhino-conjunctivtis quality of life questionnaire (RQLQ)" was used to measure the score of life quality of patient pre- and post operation.Result:1. Evaluation according to the Chinese traditional symptom scoring system,37 of 45 cases (88.2%) was complete response,4c ases (8.9%) was partial response, and 4 cases (8.9%) was ineffectiv e. Quality of life questionnaire assessment shows that nasocular and no nnasocular symptom, daily life and sleep quality, emotional state were were significantly improved after operation (P<0.001), the ability to solve practical problems also significantly increased. Among the symptoms of rhinoconjunctivitis, the sneezing and water-rhinorhea were mostsignificantly improved (p<0.0001). Compared with preoper ation, the total score of questionnaire was decreased more than 50% in 39 cases (86.7%) after operation, and decreased less than 20% in only 3 cases (6.7%).2. Follow up in 20 patients before and after operation Rhinoco-njunctivtis quality of life questionnaire (RQLQ) significant difference, P<0.05.Conclusion:The vadian neurectomy through nasal cavity under the nasal endosco peisan effective and safe technique for vasomotor rhinitis. Objective:Endoscopic vadian neurectomy is recommended to treat the patients with vasomotor rhinitis. It can not only preserve the function of nasal mucosa, but also have an excellent effect in patients with vasomotor rhinitis. This study was trying to detect the change of VIP, CGRP, SP, IL-4, IL-5 in the nasal mucosa of patients with vasomotor rhinitis pre-and post-operation, and analyze the relationship between this molecules and vasomotor rhinitis, and explore the possible mechanism of vadian neuroctomy effectively treating vasomotor rhinitis.Method:20 patients with vasomotor rhinitis were carried out vadian neuroctomy in our department June 2009 to December 2009.10 of 20 patients were followed up for 6 months, and the nasal mucosa was taken before and after operation of 3 months. The VIP, CGRP, SP, IL-4, IL-5 were detected by immunohistochemistry assay. The eosinophil cells were counted under microscopy.Result:1.there was a significant increase in the expression of VIP, CGRP, SP IL-4 and IL-5 in nasal mucosa of patients with vasomotor rhinitis compared with controls (p<0.05).2. The expression level of IL-4, IL-5, VIP, CGRP, SP in nasal mucosa of patients with vasomotor rhinitis was significantly reduced by vadian neuroctomy(p<0.05).3. there was no significantly difference in expression level of VIP,CGRP, SP, IL-4, IL-5 between postoperative patients and controls(P> 0.05).Conclusion:1. The pathogenesis of vasomotor rhinitis may be associated with neuro-related peptide and activated Th2 cytokines IL-4, IL-5.2. Vadian neuroctomy is an effective method to treat the vasomotor rhinitis by reducing the expression of neuropeptide VIP, CGRP and SP, as well as Th2 cytokine in the nasal mucosa of patients.