Posterior Nasal Neurectomy for Eosinophilic Chronic Rhinosinusitis With Allergic Rhinitis: Efficacy Study

Area of Science:

• Otorhinolaryngology
• Immunology

Background:

• Eosinophilic chronic rhinosinusitis (eCRS) and allergic rhinitis (AR) significantly impact patient quality of life.
• Current treatments may not fully address the complex pathophysiology of eCRS with AR.

Purpose of the Study:

• To evaluate the efficacy of posterior nasal neurectomy (PNN) when combined with functional endoscopic sinus surgery (FESS) in patients suffering from eCRS and moderate to severe persistent AR.
• To assess the impact of PNN on both subjective and objective symptom scores, as well as relevant cytokine levels.

Main Methods:

• A prospective study involving 42 patients with eCRS and AR, divided into an intervention group (FESS + PNN) and a control group (FESS alone).
• Symptom assessment included visual analog scale (VAS), SNOT-22, and RQLQ. Objective measures comprised modified Lund-Kennedy and Lund-Mackay CT scores.
• Postoperative nasal secretions were analyzed for cytokine concentrations (IL-5) using ELISA.

Main Results:

• The PNN group showed significantly greater improvements in subjective symptom scores (SNOT-22, RQLQ) and objective measures (Lund-Kennedy score) at 6-month follow-up compared to the control group.
• Significant reductions in eye symptoms and emotional impact were noted in the intervention group.
• Lower postoperative IL-5 concentrations were observed in patients who underwent PNN, suggesting reduced eosinophilic inflammation.

Conclusions:

• Concurrent posterior nasal neurectomy (PNN) with functional endoscopic sinus surgery (FESS) is a safe and effective treatment for patients with eCRS and AR.
• The combined approach leads to significant improvements in both patient-reported outcomes and objective clinical measures.
• Cytokine analysis supports the therapeutic benefits of PNN in managing eosinophilic inflammation associated with eCRS and AR.