Long-Term Effects of Combined Submucous Turbinectomy and Posterior Nasal Neurectomy in Patients with Allergic Rhinitis

Abstract

Submucous inferior turbinectomy (ST) can be combined with posterior nasal neurectomy (PNN) to treat intractable allergic rhinitis (AR) and vasomotor rhinitis (VR). This study assessed the long-term effects and complications of this surgical intervention. We enrolled 127 patients who had undergone combined ST and PNN. We mailed these patients card questionnaires. Of these questionnaires, we excluded the 5 patients with VR and 26 patients who had undergone concomitant endoscopic sinus surgery (ESS), because they had both AR or VR and sinusitis. Then, we assessed the questionnaire score of 31 patients with AR who had undergone combined ST and PNN. Postoperative bleeding was investigated in 127 subjects by medical records. Moreover, we compared the incidence of numbness in the palate, cheeks, or teeth between patients who had undergone PNN and those who had not. We found that 77.4% of the AR patients were satisfied with the improvement of their nasal symptoms after the operation. Although seven patients had been receiving medical treatment from an otolaryngology clinic every month before the operation, none needed any such treatment after the operation. One year postoperatively, all symptom scores were statistically decreased. However, the scores increased over time, although there was a significant improvement in nasal obstruction more than 3 years after the operation (P < 0.01). Five patients (3.9%) among 127 patients who had undergone PNN were treated for postoperative bleeding. Patients who had undergone PNN did not differ significantly from those who had not in terms of postoperative numbness in the palate, cheeks, or teeth. Endoscopic ST combined with PNN is an effective treatment for intractable AR. Further studies are required to elucidate the efficacy of this intervention.