Comparison Of Short-Term Efficacy Of Unilateral And Bilateral Posterior Nasal Neurotomy Combined With Anterior Ethmoid Neurotomy In The Treatment Of Moderate To Severe Allergic Rhinitis

Objective: To observe the short-term efficacy and complications of unilateral posterior nasal neurotomy(PNN)combined with bilateral anterior ethmoidal neurotomy(AEN)and bilateral PNN combined with bilateral AEN in the treatment of moderate to severe allergic rhinitis(AR).Methods: Patients with moderate to severe AR who underwent surgical treatment in our hospital from June 2021 to December 2022 were selected.According to the inclusion and exclusion criteria,54 patients were selected and randomly divided into the experimental group(28 patients)and control group(26 patients).The experimental group underwent unilateral PNN combined with bilateral AEN under nasal endoscopy,while the control group underwent bilateral PNN combined with bilateral AEN under nasal endoscopy.The postoperative follow-up exceeded 3 months with recording the results of the patient visual analogue scale(VAS)and allergic rhinoconjunctivitis quality of life questionnaire(RQLQ)and comparing the difference in efficacy and complications at different time points before and after surgery.Results: There were 54 patients who met the final follow-up conditions.There were significant differences in VAS and RQLQ scores between the experimental group and the control group at 1 month,3 months after operation and before operation(P < 0.05);Compared with the control group,there was no significant difference in VAS and RQLQ scores between the experimental group and the control group before and 1 month and 3months after operation(P > 0.05);According to the results of VAS score and curative effect formula,the results were divided into three types: effective,effective and ineffective.In the experimental group,21 cases were effective,5 cases were effective,and 2 cases were ineffective.The overall effective rate was 92.9%.In the control group,20 patients were markedly effective,5 cases were effective,and 1 case was ineffective.The overall effective rate was 96.2%.There was no statistical difference between the two groups(P > 0.05);There was only one case of postoperative nasal bleeding in the experimental group,and there were no complications such as dry eye and palatal numbness in the two groups.There was no statistically significant difference in the incidence of postoperative adverse events between the two groups(P > 0.05).Conclusion: The short-term clinical effect of unilateral PNN in the treatment of moderate to severe AR is comparable to that of bilateral PNN,and the postoperative symptoms can be significantly improved,but its long-term effectiveness still needs further monitoring and research;The incidence of adverse reactions in the two surgical methods is low,there is no significant difference,and the safety is worthy of recognition;Since unilateral PNN may achieve bilateral efficacy,considering the duration of surgery and the injury of surgery,unilateral surgery can be considered instead of bilateral surgery.