A Comparative Study Of The Short-term Efficacy Of Vidian Neurectomy And Posterior Nasal Neurectomy Under Nasal Endoscope In The Treatment Of Refractory Allergic Rhinitis

ObjectiveTo observe and compare the short-term clinical efficacy of vidian neurectomy and posterior nasal neurectomy under nasal endoscope in the treatment of refractory allergic rhinitis.MethodsAccording to the inclusion and exclusion criteria,46 patients with allergic rhinitis who were admitted to our department from July 2017 to June 2018 had poor effect of drug treatment.Among them,23 patients underwent vidian neurectomy(VN)and 23patients underwent posterior nasal neurectomy(PNN).After 6 months of follow-up,nasal symptoms,quality of life and medication were evaluated by Visual Analogue Scale(VAS),Rhinocon junctivitis Quality of Life Questionnaire(RQLQ)and medication scoring criteria.The short-term efficacy and adverse effects of the two methods were compared.ResultsAll the 46 patients were followed up.According to the visual analogue scale(VAS),11 cases were markedly effective,8 cases were effective and 4 cases were ineffective in VN group.The total effective rate(marked efficiency+effective rate)was82.6%.In PNN group,14 cases were markedly effective,7 cases were effective and 2cases were ineffective.The total effective rate was 91.3%.There was no significant difference between the two groups(c~2=0.192 P=0.662).According to the"RQLQ",14cases were markedly effective in VN group,6 cases were effective,3 cases were ineffective,and the total effective rate(marked efficiency+effective rate)was 87%.17cases were markedly effective in PNN group,5 cases were effective and 1 case was ineffective.The total effective rate was 95.6%.There was no significant difference between the two groups(c~2=1.095 P=0.295).The scores of nasal symptoms,quality of life and medication in VN group were significantly lower than those before operation,and there were significant differences between pre-operation and post-operation.The scores of nasal symptoms,quality of life and medication in PNN group were significantly lower than those before operation,and there were significant differences between pre-operation and post-operation.There was no significant difference in pre-operative and post-operative scores between the two groups(comparison of pre-operative score between VN group and PNN group,and comparison of post-operative score between VN group and PNN group).During the follow-up period,19(82.6%)patients in VN group had adverse reactions and 4(17.4%)patients in PNN group had adverse reactions.The difference between the two groups was significant(P<0.001).ConclusionEndoscopic vidian neurectomy and posterior nasal neurectomy are effective in the treatment of refractory allergic rhinitis,but there are some adverse reactions after operation.The incidence of adverse reactions of posterior nasal neurectomy is significantly lower than that after vidian neurectomy.It is recommended that nasal endoscopic posterior nasal neurectomy be used to treat refractory allergic rhinitis patients with ineffective drug treatment.