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常年性中重度变应性鼻炎患者鼻后神经切除术的三年疗效

Three-Year Outcomes After Posterior Nasal Neurectomy in Perennial Moderate and Severe Allergic Rhinitis Patients.

作者信息

Zhang Bin, Wang Jiayan, Wang Wei, Xu Ting, Jia Xujing, Chen Manman, Xu Ming

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Ningbo University, Ningbo, China.

Department of Otorhinolaryngology, Ningbo Municipal Hospital of TCM, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China.

出版信息

Am J Rhinol Allergy. 2025 Jan;39(1):32-37. doi: 10.1177/19458924241281521. Epub 2024 Sep 28.

Abstract

BACKGROUND

Posterior nasal neurectomy (PNN) has been shown to reduce the symptom burden of patients with perennial moderate and severe allergic rhinitis (AR).

OBJECTIVES

To evaluate the long-term safety and effectiveness of PNN for the treatment of perennial moderate and severe AR.

METHODS

A prospective 3-year single-arm study was conducted in which the reflective total nasal symptom score (rTNSS) and total non-nasal symptom score (rTNNSS) were collected preoperatively and at 3 months, 6 months, 1 year, 2 years, and 3 years postoperatively.

RESULTS

A total of 213 patients with AR were recruited and received PNN, of whom 154 patients completed the 3-year follow-up. The mean rTNSS of the long-term follow-up patients improved from 7.74 (95% confidence interval [CI] 7.507-7.974) at baseline to 2.604 (95% CI 2.221-2.986),  < .001, at 6 months and showed sustained improvement to 3.156 (95% CI 2.806-3.506),  < .001, at 3 years. The mean rTNNSS ranged from 1.301 (95% CI 1.112-1.491) at baseline to 0.564 (95% CI 0.441-0.688) ( < .001) at 6 months and showed sustained improvement to 0.641 (95% CI 0.533-0.749) ( < .001) at 3 years. The rTNSS subscores (sneezing, congestion, rhinorrhea, and itching) and rTNNSS subscores (lacrimation, eye itching, postnasal drip, and cough) remained significantly improved from the baseline at all follow-up time points (all  < .001).

CONCLUSION

Posterior nasal neurectomy significantly and sustainably alleviated nasal and non-nasal symptoms of perennial moderate and severe AR and improved patient quality of life through 3 years postprocedure.

摘要

背景

后鼻神经切除术(PNN)已被证明可减轻常年性中重度过敏性鼻炎(AR)患者的症状负担。

目的

评估后鼻神经切除术治疗常年性中重度AR的长期安全性和有效性。

方法

进行了一项为期3年的前瞻性单臂研究,术前及术后3个月、6个月、1年、2年和3年收集反射性总鼻症状评分(rTNSS)和总非鼻症状评分(rTNNSS)。

结果

共招募213例AR患者并接受PNN,其中154例患者完成了3年随访。长期随访患者的平均rTNSS从基线时的7.74(95%置信区间[CI]7.507 - 7.974)改善至6个月时的2.604(95%CI 2.221 - 2.986),P <.001,并在3年时持续改善至3.156(95%CI 2.806 - 3.506),P <.001。平均rTNNSS从基线时的1.301(95%CI 1.112 - 1.491)变化至6个月时的0.564(95%CI 0.441 - 0.688)(P <.001),并在3年时持续改善至0.641(95%CI 0.533 - 0.749)(P <.001)。rTNSS子评分(打喷嚏、鼻塞、流涕和瘙痒)和rTNNSS子评分(流泪、眼痒、鼻后滴漏和咳嗽)在所有随访时间点均较基线有显著改善(均P <.001)。

结论

后鼻神经切除术在术后3年内显著且持续地减轻了常年性中重度AR的鼻和非鼻症状,并改善了患者的生活质量。

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