Skip to main content
Log in

A Comparative Study of Symptom Scores in Patients Undergoing Posterior Lateral Nasal Neurectomy with Medical Management for Allergic Rhinitis

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Allergic rhinitis is an IgE mediated reaction against inhaled allergens. Patients not responding to medical treatment require surgery. Most surgical procedures reduce erectile tissue of inferior turbinates. Vidian neurectomy reduces nasal hyperreactivity and secretions by reducing parasympathetic supply, but results in loss of lacrimation. Transnasal posterior nasal neurectomy is more selective denervation procedure which preserves lacrimation. There are few studies documenting the outcome of posterior lateral nasal neurectomy. Posterior lateral nasal neurectomy can be good treatment option for perennial allergic rhinitis. To assess and compare the symptom scores in patients undergoing posterior lateral nasal neurectomy and medical management for allergic rhinitis. This prospective study included 50 patients diagnosed as perennial allergic rhinitis as per the ARIA guidelines. 25 patients underwent posterior lateral nasal neurectomy and 25 patients underwent medical management using fluticasone nasal spray and Montelukast with Levocetirizine. Pre and post-treatment Total nasal symptom scores and mini rhinoconjunctivitis quality of life questionnaire scores were compared. Symptoms reduced significantly in both surgery and medical management group. However in surgery group, more patients showed more than 50% improvement in symptoms. Posterior lateral nasal neurectomy is minimally invasive treatment for patients with perennial allergic rhinitis not responding to or not complying with medical treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Bousquet J, Khaltaev N, Cruz AA et al (2008) Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the world health organization, GA(2)LEN and allergen). Allergy 63(Suppl 86):8–160

    Article  Google Scholar 

  2. Chandrika D (2017) Allergic rhinitis in India: an overview. Int J Otorhinolaryngol Head Neck Surg 3(1):1–6

    Article  Google Scholar 

  3. Lai CK, Beasley R, Crane J, Foliaki S, Shah J, Weiland S (2009) Global variation in the prevalence and severity of asthma symptoms: phase three of the international study of asthma and allergies in childhood (ISAAC). Thorax 64:476–483

    Article  CAS  Google Scholar 

  4. Bousquet J, Van Cauwenberge P, Khaltaev N, Aria Workshop Group, World Health Organization (2001) Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 108:S147–S334

    Article  CAS  Google Scholar 

  5. Lemanske R (1998) A review of the current guidelines for allergic rhinitis and asthma. J Allergy Clinimmunol 101(2):392–6

    Article  Google Scholar 

  6. Cardona V, Luengo O, Labrador-Horrillo M (2017) Immunotherapy in allergic rhinitis and lower airway outcomes. Allergy 72(1):35–42

    Article  CAS  Google Scholar 

  7. Nagalingeswaran A, Kumar RD (2020) Newer surgical options for nasal allergy. Indian J Otolaryngol Head Neck Surg 72(1):133–139

    Article  Google Scholar 

  8. Konno A, Togawa K (1979) Vidian neurectomy for allergic rhinitis: evaluation of long–term results and some problems concerning operative therapy. Arch Otorhinolaryngol 225:67–77

    Article  CAS  Google Scholar 

  9. Krespi YP, Wilson KA, Kizhner V (2020) Laser ablation of posterior nasal nerves for rhinitis. Am J Otolaryngol 41:102396

    Article  Google Scholar 

  10. Kikawada T (2007) Endoscopic posterior nasal neurectomy: An alternative to vidian neurectomy. Oper Tech Otolaryngol Head Neck Surg 18(4):297–301

    Article  Google Scholar 

  11. Kobayashi T, Hyodo M, Nahamura K, Komobuchi H, Honda N (2012) Resection of peripheral branches of the posterior nasal nerve compared to conventional posterior neurectomy in severe allergic rhinitis. Auris Nasus Larynx 39:593–596

    Article  Google Scholar 

  12. Ahilasamy N, Rajendran Dinesh K (2019) Endoscopic posterior nasal neurectomy. J Laryngol Otol 133(9):825–829

    Article  CAS  Google Scholar 

  13. Cassano M, Russo L, Del Giudice AM, Gelardi M (2012) Cytologic alterations in nasal mucosa after sphenopalatine artery ligation in patients with vasomotor rhinitis. Am J Rhinol Allergy 26(1):49–54

    Article  Google Scholar 

  14. Felix V, Sreeparvathi A, Narendrakumar V, Vijayan D (2015) Endoscopic posterior nasal neurectomy for rhinorrhoea. Chettinad Health City Med J 4(4):164–166

    Google Scholar 

  15. Bleier BS, Schlosser RJ (2011) Endoscopic anatomy of the postganglionic pterygopalatine innervation of the posterolateral nasal mucosa. Int Forum Allergy Rhinol 1:113–117

    Article  Google Scholar 

Download references

Funding

We do not have any funding sources.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to K. C. Prasad.

Ethics declarations

Conflict of interest

The author declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (XLSX 14 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Joseph, L., Prasad, K.C. & Mohiyuddin, S.M.A. A Comparative Study of Symptom Scores in Patients Undergoing Posterior Lateral Nasal Neurectomy with Medical Management for Allergic Rhinitis. Indian J Otolaryngol Head Neck Surg 74, 402–408 (2022). https://doi.org/10.1007/s12070-021-02930-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-021-02930-0

Keywords

Navigation