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

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.