Management of Perennial Allergic Rhinitis Complicated by Rhinosinusitis Using Ultrasound-Guided Sphenopalatine...

Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) are common upper respiratory tract diseases that frequently coexist. While not life-threatening, these conditions significantly diminish quality of life, impose substantial socioeconomic burdens due to their chronic and recurrent nature, and negatively impact mental health. In some cases, AR and CRS have been associated with severe outcomes, including suicidal tendencies. This report presents two cases of women aged 42 and 37 years who experienced recurrent AR and CRS symptoms, such as persistent nasal congestion, rhinorrhea, which led to difficulties in conversation during meals and sleep disturbances, for over 20 years, despite undergoing conventional treatments. Both patients received an 8-12 week treatment regimen consisting of Socheongryong-tang (SCRT) and ultrasound-guided acupuncture targeting the sphenopalatine ganglion (SPG). Treatment efficacy was assessed using nasal endoscopic findings, Rhinoconjunctivitis Quality of Life Questionnaire scores, and Total Nasal Symptom Scores. Significant post-treatment improvements were observed, and these effects persisted for 3 months after treatment cessation, with no significant adverse events reported. While Intranasal corticosteroids are the standard treatment for AR and CRS, approximately 30% of patients either experience insufficient symptom relief or discontinue their use due to adverse effects, often leading to symptom relapse. In contrast, the combination of SCRT and SPG-targeted ultrasound-guided acupuncture may offer a promising alternative treatment option, demonstrating sustained symptom improvement without significant adverse effects.