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鼻黏膜自主神经反应在翼管神经切断术治疗变应性鼻炎疗效评估中的应用:一项前瞻性研究

Use of nasal mucosal autonomic nerve response in efficacy evaluation of vidian neurectomy for allergic rhinitis: a prospective study.

作者信息

Liu Linzheng, Ma Na, Niu Yan, Peng Yuping, Li Yan, Shen Jiangjiang, He Jiameng, Sun Jindi

机构信息

Department of Otolaryngology Head and Neck Surgery, Yulin City First Hospital of Yan'an University, Yulin, China.

Department of Otolaryngology Head and Neck Surgery, Yan'an University, Yan'an, China.

出版信息

Front Neurosci. 2025 Mar 25;19:1424629. doi: 10.3389/fnins.2025.1424629. eCollection 2025.

DOI:10.3389/fnins.2025.1424629
PMID:40201188
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11975872/
Abstract

OBJECTIVE

To evaluate the use of nasal mucosal autonomic nerve responses as an objective indicator for assessing the efficacy of vidian neurectomy (VN) in treating allergic rhinitis (AR).

METHODS

Thirty-five patients with moderate to severe AR and 35 healthy controls were included. Autonomic nerve responses were measured before and 1 month after VN surgery, using respiratory stimulation on the nasal mucosa and the opisthenar area. Three waveform types (P-type, N-type and M-type) were identified.

RESULTS

While three waveform types were identified in the nasal mucosa, only the M-type was observed in the opisthenar sympathetic skin response. Preoperative measurements showed higher autonomic responses in patients with AR compared with controls. Following VN, the responses in patients with AR decreased significantly, aligning closely with the control group. No significant changes were observed in the opisthenar responses, indicating a localised effect of VN. Comorbidities such as nasal polyps, sinusitis and deviated septum did not impact the results.

CONCLUSION

Nasal mucosal autonomic nerve response provides a reliable, objective measure for evaluating the effectiveness of VN in treating AR.

摘要

目的

评估鼻黏膜自主神经反应作为评估翼管神经切断术(VN)治疗变应性鼻炎(AR)疗效的客观指标的应用价值。

方法

纳入35例中重度AR患者和35例健康对照者。在VN手术前及术后1个月,通过对鼻黏膜和小鱼际区域进行呼吸刺激来测量自主神经反应。识别出三种波形类型(P型、N型和M型)。

结果

虽然在鼻黏膜中识别出三种波形类型,但在小鱼际交感皮肤反应中仅观察到M型。术前测量显示,AR患者的自主神经反应高于对照组。VN术后,AR患者的反应显著降低,与对照组密切一致。小鱼际反应未观察到显著变化,表明VN具有局部效应。鼻息肉、鼻窦炎和鼻中隔偏曲等合并症不影响结果。

结论

鼻黏膜自主神经反应为评估VN治疗AR的有效性提供了可靠的客观指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eec6/11975872/8f99e808199a/fnins-19-1424629-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eec6/11975872/ca7cd94593b0/fnins-19-1424629-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eec6/11975872/8f99e808199a/fnins-19-1424629-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eec6/11975872/ca7cd94593b0/fnins-19-1424629-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eec6/11975872/8f99e808199a/fnins-19-1424629-g002.jpg

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本文引用的文献

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Eur Ann Allergy Clin Immunol. 2024 Jan 23. doi: 10.23822/EurAnnACI.1764-1489.327.
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The Relationship between Fine Particle Matter (PM2.5) Exposure and Upper Respiratory Tract Diseases.细颗粒物(PM2.5)暴露与上呼吸道疾病之间的关系。
J Pers Med. 2024 Jan 16;14(1):98. doi: 10.3390/jpm14010098.
3
Endoscopic vidian and vidian-branch neurectomy for refractory allergic rhinitis: A systematic review.
内镜下翼管神经及翼管神经分支切除术治疗难治性变应性鼻炎:一项系统评价
Int Forum Allergy Rhinol. 2024 Mar;14(3):679-694. doi: 10.1002/alr.23259. Epub 2023 Sep 16.
4
Association of serum CD14 level and functional polymorphism C-159T in the promoter region of CD14 gene with allergic rhinitis.血清 CD14 水平与 CD14 基因启动子区功能性多态性 C-159T 与变应性鼻炎的关系。
Clin Exp Med. 2023 Dec;23(8):4861-4869. doi: 10.1007/s10238-023-01097-y. Epub 2023 Jun 7.
5
Imaging of Common Oral Cavity, Sinonasal, and Skull Base Pathology.常见口腔、鼻窦和颅底病变的影像学检查
Oral Maxillofac Surg Clin North Am. 2023 Aug;35(3):xi. doi: 10.1016/j.coms.2023.03.003. Epub 2023 Apr 7.
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Allergic asthma: An indication for allergen immunotherapy.过敏性哮喘:变应原免疫疗法的一种适应症。
Allergol Select. 2023 Mar 1;7:33-38. doi: 10.5414/ALX02332E. eCollection 2023.
7
Sixty cases of refractory allergic rhinitis treated by vidian trunk or branch neurectomy: A single-center observational study.电切翼管神经分支治疗难治性变应性鼻炎 60 例:单中心观察性研究。
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8
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