Department of Otorhinolaryngology, Head and Neck Surgery, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang Province, China.
Medicine (Baltimore). 2022 Nov 11;101(45):e31704. doi: 10.1097/MD.0000000000031704.
To investigate the effect of vidian trunk neurectomy and selective vidian branch neurectomy on treating moderate-to-severe persistent allergic rhinitis. Sixty patients with moderate-to-severe persistent allergic rhinitis treated at Zhejiang Hospital of Integrative Medicine participated in this study from June 2018 to June 2020. The patients in the observation group (n = 40) underwent a vidian trunk neurectomy. The patients in the control group (n = 20) underwent a vidian branch neurectomy. The patients in both groups were followed up after 6 months, 1 year, and 2 years of surgery. The efficacy was evaluated based on the AR diagnostic and the efficacy assessment criteria. The 4 symptoms of sneezing, runny nose, nasal congestion, and nasal itch were scored as efficacy indices before and 6 months, 1 year, and 2 years after surgery. Nasal endoscopy or sinus CT was performed to assess the postoperative inferior turbinate swelling. The postoperative tear secretion was followed up in both groups, and patients with dry eyes were counted in combination with ocular symptoms. The data recorded before and after surgery and between the 2 groups were analyzed statistically. The observation group had signs of 2.73 ± 0.452 before surgery, 1.20 ± 0.405 6 months after surgery, 1.25 ± 0.494 1 year after surgery, and 1.30 ± 0.564 2 years after surgery. The control group had signs of 2.75 ± 0.444 before surgery, 1.45 ± 0.686 6 months after surgery, 1.75 ± 0.716 1 year after surgery, and 1.90 ± 0.852 2 years after surgery. The between-subjects effect test between the groups showed an overall significant difference (P < .05). The overall effective rate 2 years postoperatively was 38/40 (95.0%) in the observation group and 10/20 (50%) in the control group. Fisher's exact test showed a significant difference between the groups. No patient in either group had dry eyes 1.5 years after surgery. Both vidian trunk neurectomy and selective vidian branch neurectomy have good immediate therapeutic effects, and vidian trunk neurectomy has higher long-term efficacy than selective vidian branch neurectomy.
为了探讨翼管干神经切断术和选择性翼管分支神经切断术治疗中重度持续性变应性鼻炎的效果。2018 年 6 月至 2020 年 6 月，浙江中医药大学附属第一医院收治的 60 例中重度持续性变应性鼻炎患者参与本研究。观察组（n=40）行翼管干神经切断术，对照组（n=20）行翼管分支神经切断术。两组患者均在术后 6 个月、1 年和 2 年进行随访。根据 AR 诊断和疗效评估标准评价疗效。在手术前后 6 个月、1 年和 2 年，将打喷嚏、流鼻涕、鼻塞和鼻痒 4 种症状作为疗效指标进行评分。对术后下鼻甲肿胀进行鼻内镜或鼻窦 CT 评估。两组均对术后泪液分泌进行随访，结合眼部症状计算干眼患者人数。对手术前后及两组间的数据进行统计学分析。观察组术前体征为 2.73±0.452，术后 6 个月为 1.20±0.405，术后 1 年为 1.25±0.494，术后 2 年为 1.30±0.564。对照组术前体征为 2.75±0.444，术后 6 个月为 1.45±0.686，术后 1 年为 1.75±0.716，术后 2 年为 1.90±0.852。组间整体效应检验显示，两组总体差异有统计学意义（P<.05）。观察组术后 2 年总有效率为 38/40（95.0%），对照组为 10/20（50%）。Fisher 确切概率法显示两组差异有统计学意义。术后 1.5 年两组均无干眼患者。翼管干神经切断术和选择性翼管分支神经切断术均有较好的即刻疗效，翼管干神经切断术的长期疗效优于选择性翼管分支神经切断术。
