Efficacy Of Posterior Nasal Neurectomy For Allergic Rhinitis Combined With Chronic Rhinosinusitis With Nasal Polyps

Objective:To investigate the control of recurrence of nasal polyps and improvement in symptoms after endoscopic posterior nasal neurectomy(PNN)for the treatment of allergic rhinitis combined with chronic rhinosinusitis with nasal polyps(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.Visual analog scale(VAS),Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ)and the 22-item Sino-Nasal Outcomes Test(SNOT-22)scores and postoperative nasal endoscopy were used to evaluate the improvement in symptoms and the recurrence of nasal polyps in the two groups before and after surgery.Results:All symptoms improved postoperatively in both groups.The experimental group had better control of sneezing(p<0.05)and rhinorrhea(p<0.01)than the control group,but there was no significant difference between the two groups in the improvement in nasal congestion and hyposmia(p>0.05).The recurrence rate was 18.8%(9/48)in the experimental group and 40.9%(9/22)in the control group to the end of follow-up,and there had statistical difference(?~2=3.878,P=0.049).For those who underwent surgery more than six 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(?~2=0.483,p=0.487).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.