Department of Otorhinolaryngology Head and Neck Surgery, XuanWu Hospital, Capital Medical University, Beijing, China.
Beijing Hegongye Hospital, Beijing, China.
ORL J Otorhinolaryngol Relat Spec. 2021;83(5):327-334. doi: 10.1159/000512083. Epub 2021 May 5.
The aim of this study was to investigate the efficacy of endoscopic selective vidian neurectomy in the treatment of severe persistent allergic rhinitis (AR) combined with chronic rhinosinusitis (CRS) with nasal polyps (ARwCRSwNP).
One hundred thirty patients with moderate to severe persistent ARwCRSwNP were enrolled at Xuanwu Hospital, Capital Medical University, from September 2015 to September 2017. Patients were divided into 2 groups. Sixty-one patients (the control group) underwent conventional surgical treatment for CRS with nasal polyps and received conservative treatment for AR. Sixty-nine patients (the experimental group) received conventional surgical treatment for CRS with nasal polyps plus endoscopic selective vidian neurectomy with amputation of the posterior nasal nerve and pharyngeal branch of the vidian nerve. Clinical parameters, including visual analog scale (VAS) score, Lund-Kennedy endoscopic mucosal morphology score, and Lund-Mackay sinus computed tomography (CT) scan lesion range score, were used to analyze and evaluate the preoperative and postoperative data. Comparisons were based on patient scores, and preoperative and postoperative scores obtained at 6, 12, and 24 months were analyzed.
The experimental group had higher therapeutic efficacy in nasal obstruction, nasal itching, rhinorrhea, sneezing, and general symptoms than the control group (p < 0.05). No complications such as tear-secretion disorder or atrophic rhinitis occurred in the experimental group, and no significant difference in complications incidence was observed between the 2 groups (p > 0.05).
Endoscopic selective vidian neurectomy is an effective and safe technique for the management of moderate to severe persistent ARwCRSwNP.
本研究旨在探讨内镜选择性翼管神经切断术治疗伴有鼻息肉的中重度持续性变应性鼻炎（AR）合并慢性鼻-鼻窦炎（CRS）（ARwCRSwNP）的疗效。
2015 年 9 月至 2017 年 9 月，首都医科大学宣武医院收治 130 例中重度持续性 ARwCRSwNP 患者。患者分为 2 组，61 例（对照组）接受常规手术治疗伴鼻息肉的 CRS，并接受 AR 的保守治疗；69 例（实验组）接受常规手术治疗伴鼻息肉的 CRS 加内镜选择性翼管神经切断术，切断后鼻神经和翼管神经咽支。采用视觉模拟量表（VAS）评分、Lund-Kennedy 内镜黏膜形态评分和 Lund-Mackay 鼻窦 CT 扫描病变范围评分分析和评估术前和术后数据。基于患者评分进行比较，分析和评估术前、术后 6、12 和 24 个月的评分。
实验组鼻塞、鼻痒、流涕、打喷嚏和全身症状的治疗效果均优于对照组（p < 0.05）。实验组无泪液分泌紊乱或萎缩性鼻炎等并发症，两组并发症发生率无显著差异（p > 0.05）。
内镜选择性翼管神经切断术治疗中重度持续性 ARwCRSwNP 是一种有效且安全的技术。
