Clinical Efficacy of Single Vidian Neurectomy in Chronic Rhinosinusitis with Nasal Polyps and Allergic Rhinitis.

Journal: Journal Of The College Of Physicians And Surgeons--Pakistan : JCPSP
Treatment Used: Single Vidian Neurectomy (sVN)
Number of Patients: 55
Published:
MediFind Summary

Summary: This study investigated the effectiveness of single Vidian neurectomy (nerve block which involves either severing or removing the vidian nerve; sVN) in the treatment of chronic rhinosinusitis with nasal polyps (chronic nasal and sinus irritation and inflammation that persists for at least 12 weeks with noncancerous growths on the tissues that line the nose and sinuses; CRSwNP) and allergic rhinitis (allergic reaction that causes sneezing, congestion, itchy nose and sore throat; AR).

Conclusion: Single Vidian neurectomy (nerve block which involves either severing or removing the vidian nerve) had better effectiveness in patients with chronic rhinosinusitis with nasal polyps (chronic nasal and sinus irritation and inflammation that persists for at least 12 weeks with noncancerous growths on the tissues that line the nose and sinuses) and allergic rhinitis (allergic reaction that causes sneezing, congestion, itchy nose and sore throat) and had the potential to reduce recurrence rates. It seemed to be a safe and effective treatment.

Abstract

Objective: To investigate the clinical efficacy of single Vidian neurectomy (sVN) in the treatment of chronic rhinosinusitis with nasal polyps and allergic rhinitis (CRSwNP &AR). Methods: Descriptive study.   Place and Duration of Study: Otolaryngology-Head &Neck Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China, February 2016 to February 2019. Methods: Patients meeting the diagnostic criteria for AR and CRSwNP confirmed after assessment by an ENT physician; moderately severe and persistent AR, aged ≥18 years to ≤70 years; and testing positive for sIgE and were regularly treated with medications for three months or more before surgery with unsatisfactory symptom control. Exclusion criteria were patients with acute exacerbations of sinusitis or fungal sinusitis combined with nasal polyps, intolerant to aspirin, acute infection or sinus tumours; contraindications to general anaesthetic surgery or oral corticosteroids; and those who have received allergen immunotherapy, corticosteroids and antihistamines within one year. The relevant epidemiological data were collected, including IgE level, VAS, RQLQ, and the Lund-Kennedy scores, to assess patients' clinical symptoms and quality of life before and after surgery. Results: Fifty-five patients were followed up for two years after surgery, and statistical analysis was performed using SPSS version 25.0. It was found that VAS scores, RQLQ scores, and Lund-Kennedy scores of the patients who underwent sVN were significantly lower at six months (all p <0.01), one year (all p <0.01, and two years all p <0.01) after surgery compared with those before surgery. Conclusions: sVN has better efficacy in patients with CRSwNP&AR, has the potential to reduce its recurrence rate, and seems to be a safe and effective treatment.

Background: Chronic rhinosinusitis with nasal polyps, Allergic rhinitis, Eosinophilic chronic rhinosinusitis with nasal polyps, Single Vidian neurectomy, Clinical efficacy.

Authors
Hedi Zhuo, Yanjie Wang, Xueping Qi, Jinmei Xue, Yunfang An, Changqing Zhao

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