| Objective:To evaluate the curative effect of endoscopic-assisted posterior nasal neurotomy on patients with refractory allergic rhinitis.Methods:50 patients with allergic rhinitis admitted to our department from S eptember 2017 to September 2018 were selected,which were divided int o observation group and control group with 25 cases each.In the observ ation group,bilateral posterior rhinotomy was performed simultaneously with transnasal endoscopic sinus surgery;The control group was performe d without posterior nasal nerve resection.The patients in both groups w ere followed up for 3 months,6 months,and 12 months after surgery,and the clinical efficacy of posterior nasal nerve resection in the treatme nt of AR was evaluated by the changes of symptom score and physical sign score through the comparison of preoperative and postoperative in two groups.Results:There were 50 patients with postoperative follow-up time of 3 months,25 patients in the observation group and the control group.There were 32 patients with postoperative follow-up time of 6 months,16 patients in the observation group and the control group.The postoperative follow-up time was 12 There were 20 cases in the month,and 10 cases in the observation group and the control group.1.Both two groups showed significant improvement in nasal symptoms after surgery compared with that before surgery.The nasal symptoms between two groups of preoperative was showed no significant difference(P>0.05).There were significant differences between the two groups of 3 months,6 months and 12 months(P<0.05).The observation group had more significant improvement in nasal symptoms than the control group.2.The total score of postoperative symptoms(nasal symptoms scor e + ocular symptoms score)within the two groups were significantly im proved compared with that preoperation.Comparison of total symptom sc ores between the two groups: There was no significant difference betwe en the two groups(P>0.05).There were significant differences between the two groups at 3 months,6 months and 12 months after surgery(P<0.05).The observation group had more significant improvement than the c ontrol group.3.The scores of asthma symptoms in the observation group and th e control group were not significantly changed after surgery.There were no significant differences in preoperative and postoperative of asthma sy mptom scores and physical scores between the observation group and th e control group,separately(P>0.05).There was no significant difference i n postoperative asthma control and recovery of the mucosa between the two groups.4.The overall symptom improvement rate was 100% in the observ ation group at 3 months,6 months and 12 months after the operation,while 2 cases(2/25,8%)in the control group were invalid at 3 month s after the operation,and 1 case(1/16,6%)was invalid after 6 month s of operation.The overall symptom improvement rate was 100%(10/10)at 12 months after the operation.Overall symptoms improved in both tw o groups,but the improvement was more significant in the observation group.5.In the observation group,3 patients(3/16,19%)stopped using r hinitis control drugs at 6 months after surgery,and 2 patients(2/10,20%)stopped using rhinitis control drugs at 12 months after surgery,while n one of the patients in the control group stopped using rhinitis control dr ugs.6.No one had postoperative complications such as active nosebleed,nasal adhesion,polyp recurrence,pharyngeal dryness in this study.Only two patients(2/16,13%)in the observation group had soft palate num bness after postnasal nerve amputation,but recovered within 6 months a fter surgery.Conclusion:The treatment of refractory allergic rhinitis by endoscopic-assisted p osterior nasal neurotomy is simple,micro-traumatic,and has obvious im provement in short term and markedly curative effect in nasal symptoms. |
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