翼管神经切断术治疗2型慢性鼻窦炎伴过敏性鼻炎的临床疗效分析

doi:10.6040/j.issn.1673-3770.0.2022.471

Abstract

Abstract: Objective To investigate the clinical efficacy and vidian neurectomy(VN)in the treatment of type 2 chronic rhinosinusitis with allergic rhinitis(CRSwAR). Methods This was a retrospective study of 47 patients with moderate to severe type 2 CRSwAR who presented to our department for endoscopic sinus surgery(ESS)combined with VN surgery, from September 2019 to September 2021. The severity and extent of the patient's disease preoperatively and 1 year postoperatively were assessed using the sinonasal outcome test-22(SNOT-22)questionnaire, allergy-related serology(peripheral blood eosinophils, serum total immunoglobulin E, serum allergens, etc.), electronic nasopharyngoscopy(Lund-Kennedy scale), and the sinus CT(Lund-Mackay scale). Results From the analysis, the preoperative and 1-year postoperative SNOT-22 score was ［38.00(23.00,54.25)］ and ［10.00(5.00,18.50)］, respectively. The postoperative score was significantly lower than the preoperative score, and the difference before and after treatment was statistically significant(P<0.001). The clinical symptoms of nasal obstruction, sneezing, clear runny nose, rhinorrhea and reduction of smell all improved after treatment as indicated by the significantly lower scores after treatment than before treatment(P<0.001). The preoperative Lund-Kennedy and Lund-Mackay scores were ［9.00(6.75,12.00)］ and ［15.50(10.75,22.00)］ respectively, while 1 year postoperatively, these scores were significantly different at ［3.00(2.00,4.00)］ and ［3.50(1.00,6.50)］ respectively(P<0.001). One month after surgery, 18 patients(38.30%)had dry eyes and 2 patients(4.26%)had numbness in the palate. At 1 year follow-up, except for 2 patients who still had dry eyes, the symptoms of dry eyes and numbness in the palate basically disappeared and no serious complications such as cranial or orbital problems occurred. The total effective rate of treatment at 1 year after surgery was 89.36% for patients with type 2 CRSwAR. The changes in peripheral blood eosinophils, total serum immunoglobulin E and serum allergens before and after treatment were not statistically significant(P=0.130,P=0.184,P=0.763). Conclusion ESS combined with VN is a safe and effective treatment for moderate to severe type 2 CRSwAR, significantly improving symptoms of nasal obstruction, rhinorrhea, sneezing and reduction of smell without serious complications.

Key words: Vidian neurectomy, Endoscopic sinus surgery, Type 2 chronic rhinosinusitis, Allergic rhinitis, Clinical efficacy

CLC Number:

R765.21

WANG Xiaoai, ZHANG Qianqian, CHENG Xiangyu, LI Zhipeng, ZHANG Weitian, YE Haibo. A clinical efficacy analysis of vidian neurectomy in the treatment of type 2 chronic rhinosinusitis with allergic rhinitis[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(5): 42-49.

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A clinical efficacy analysis of vidian neurectomy in the treatment of type 2 chronic rhinosinusitis with allergic rhinitis

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