Endoscopic posterior nasal nerve neurectomy efficacy and outcome in cases of allergic rhinitis

Abstract

Abstract Background Allergic rhinitis (AR) can substantially impair quality of life (QOL), particularly in patients refractory to maximal medical therapy. Endoscopic posterior nasal nerve neurectomy (PNN) is a surgical option that preserves mucosa and aims to reduce nasal rhinorrhea, congestion, and sneezing. Methods This prospective single arm interventional study was conducted on 40 patients with AR symptoms refractory to maximum medical therapy. Patients underwent endoscopic PNN and were evaluated preoperatively and postoperatively using validated scores and endoscopic nasal examination. This work aimed to assess the efficacy and outcome of endoscopic PNN in patients with AR. Results Visual Analogue Scale (VAS) scores for sneezing, rhinorrhea, nasal congestion, itching, and postnasal drip showed marked reduction, with approximately 90% of patients reporting none-to-occasional symptoms by 6 months. Endoscopic grading demonstrated substantial improvement in nasal airway patency, with a decrease in higher obstruction grades over time ( P < 0.001). QOL improved substantially, with median QOL scores increasing from 2 preoperatively to 7 at 6 months. Post-operative complications were mild and transient, with no major adverse events reported. Conclusion Endoscopic PNN neurectomy was a safe and effective treatment for AR, providing substantial symptom relief, improved nasal airway patency, and marked enhancement in QOL.