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后鼻神经切除术是顽固性变应性鼻炎的确定性治疗方法吗:一项前瞻性研究。

Is posterior nasal neurectomy the definitive treatment for intractable allergic rhinitis: A prospective study.

作者信息

Rajdev Saivi, Goel Khushboo, Bhagat Sanjeev, Sahni Dimple, Sharma Dinesh K, Yadav Vishav

机构信息

Department of Otorhinolaryngology and Head & Neck Surgery Government Medical College Patiala Punjab India.

出版信息

World J Otorhinolaryngol Head Neck Surg. 2023 Oct 10;10(4):290-295. doi: 10.1002/wjo2.133. eCollection 2024 Dec.

Abstract

OBJECTIVES

Allergic rhinitis (AR) has a significant effect on the quality of life and accounts for unproductive times at work and school, causes disturbed sleep patterns and can lead to daytime somnolence. It is fairly prevalent in the world with medical management still being the mainstay of treatment. Patients suffer for a significant number of years before they undergo surgical management for their intractable rhinitis. Thus, this prospective observational study was conducted to reinforce the proficiency of posterior nasal neurectomy in being an effective method for ending this suffering.

METHODS

Thirty patients with troublesome intractable rhinitis underwent posterior nasal neurectomy. Pre- and postoperative Visual Analogue Scale (VAS) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores were compared to study the improvement in nasal and ocular symptoms. Each domain of these scores was studied separately.

RESULTS

The mean reduction in the VAS was from 6.76 ± 0.884 preoperatively to a mean of 5.33 ± 0.675 at 1 month, 3.81 ± 0.462 at 3 months and 2.53 ± 0.405 at 6 months postoperatively. The mean RQLQ score was reduced from preoperative 4.22 ± 1.091 to a mean of 3.82 ± 1.072 at 1 month, 3.55 ± 1.063 at 3 months and 3.18 ± 1.173 at 6 months postoperatively. Thus, a statistically significant improvement was seen in both mean VAS and RQLQ scores ( < 0.001), and also when each domain was compared separately.

CONCLUSION

Endoscopic posterior nasal neurectomy may be an effective way of improving symptoms in patients with intractable AR and freeing them from long-term medical regimes, thereby improving their quality of life.

摘要

目的

变应性鼻炎(AR)对生活质量有显著影响,导致工作和学习效率低下,引起睡眠模式紊乱,并可导致日间嗜睡。它在全球相当普遍,药物治疗仍然是主要的治疗方法。患者在接受顽固性鼻炎手术治疗之前会遭受数年的痛苦。因此,开展这项前瞻性观察性研究以加强后鼻神经切除术作为终止这种痛苦的有效方法的熟练度。

方法

30例顽固性鼻炎患者接受了后鼻神经切除术。比较术前和术后视觉模拟量表(VAS)和鼻结膜炎生活质量问卷(RQLQ)评分,以研究鼻和眼部症状的改善情况。分别研究这些评分的每个领域。

结果

VAS的平均降低值从术前的6.76±0.884降至术后1个月时的平均5.33±0.675、3个月时的3.81±0.462和6个月时的2.53±0.405。RQLQ平均评分从术前的4.22±1.091降至术后1个月时的平均3.82±1.072、3个月时的3.55±1.063和6个月时的3.18±1.173。因此,平均VAS和RQLQ评分均有统计学显著改善(<0.001),且在分别比较每个领域时也是如此。

结论

内镜下后鼻神经切除术可能是改善顽固性AR患者症状并使其摆脱长期药物治疗方案的有效方法,从而改善他们的生活质量。

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本文引用的文献

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Effect of posterior nasal neurectomy on the suppression of allergic rhinitis.鼻后神经切断术对过敏性鼻炎抑制作用的影响。
Am J Otolaryngol. 2020 May-Jun;41(3):102410. doi: 10.1016/j.amjoto.2020.102410. Epub 2020 Jan 27.
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Surgical options for the allergic rhinitis patient.变应性鼻炎患者的手术选择。
Curr Opin Otolaryngol Head Neck Surg. 2012 Jun;20(3):199-204. doi: 10.1097/MOO.0b013e328352b821.
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Allergic rhinitis.变应性鼻炎。
Lancet. 2011 Dec 17;378(9809):2112-22. doi: 10.1016/S0140-6736(11)60130-X. Epub 2011 Jul 23.
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Midterm outcomes of outfracture of the inferior turbinate.下鼻甲骨折外移术的中期疗效。
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