A 7-year Follow-up Analysis Of High-intensity Focused Ultrasound In The Treatment Of Patients With Allergic Rhinitis

Objective:To analyze the persistent efficacy of high-intensity focused ultrasound(HIFU)in the treatment of perennial allergic rhinitis.Methods:from November 2009 to December 2012,75 patients with persistent moderate to severe allergic rhinitis diagnosed in the First Affiliated Hospital of China Medical University and ineffective conservative treatment who were included in the study.Among them,10 cases were lost,the lost rate was 13.3%,and 65 cases were finally completed.The long-term efficacy was determined by telephone follow-up and pathological examination.All patients were followed up by telephone,and asked about the severity of nasal congestion,sneezing,runny water and rhinopruritus at 4 time points before treatment,and 1 year,2 years and 7 years after treatment.The severity of symptoms was assessed by visual analogue scale(VAS).Kruskal Wallis statistical method was used to compare the VAS scores of patients with nasal obstruction,sneezing,runny nose and rhinopruritus before treatment with the scores of 1,2 and 7 years after operation.Among the 65 patients who completed the study,9 patients who agreed to come to our hospital for reexamination were selected as the experimental group A;between January 2019 and December,10 patients diagnosed as perennial persistent moderate and severe allergic rhinitis were randomly selected as the control group B;10 patients diagnosed as deviation of nasal septum were randomly selected as the blank control group C(on behalf of non allergic rhinitis patients).In group A,B and C,the anterior mucosa of left inferior turbinate was selected before treatment,and eosinophils,other inflammatory cells and submucous glands were counted under 400 times microscope after conventional sectioning 、 HE staining.Kruskal Wallis test was used to analyze and compare the differences among groups.Results:1.Seven years after the treatment,the above four main symptoms were still significantly improved compared with those before the treatment(P < 0.01),in which the effective rate was 30.77%(20 cases / 65 cases),and the effective rate was 41.54%(27cases / 65 cases).2.VAS score showed that the total effective rate was 90.77%(59 cases/ 6 cases 5),84.61%(55 cases / 65 cases)in two years and 72.31%(47 cases / 65 cases)in seven years.Kruskal Wallis statistical method was used to compare the differences of VAS scores of four main symptoms in one and two years,two and seven years after treatment,results there was no significant difference(P > 0.05).It is suggested that although the four symptoms have a tendency to relapse with the extension of time,the effective rate will remain relatively high after years.3.In pathological examination,the number of eosinophils in group A was significantly lower than that in group B(P < 0.05);the number of eosinophils in group A was significantly higher than that in group C(P >0.05);the number of other inflammatory cells in group A,B and C was no significant difference(P > 0.05);the number of submucous glands in group A was significantly lower than that in group B and C(P < 0.01).Conclusion : HIFU can significantly improve the symptoms of patients with allergic rhinitis and maintain the therapeutic effect for a long time,suggesting that focused ultrasound as a means of allergic rhinitis should be further explored and promoted by clinicians.