Long-term results of bilateral endoscopic vidian neurectomy in the management of moderate to severe persistent allergic rhinitis

摘要

Objective: To evaluate the long-term efficacy of bilateral endoscopic vidian neurectomy in the management of moderate to severe persistent allergic rhinitis. Design: A prospective reassessment of the postoperative long-term results of bilateral endoscopic vidian neurectomy using the Rhinoconjunctivitis Quality of Life Questionnaire and visual analog scale for patients with moderate to severe persistent allergic rhinitis. Setting: University hospital. Patients: A total of 236 patients with moderate to severe persistent allergic rhinitis were divided into the following 3 treatment groups: those who underwent bilateral endoscopic vidian neurectomy (group 1, n=93), those who underwent partial inferior turbinectomy and/or septoplasty (group 2, n=51), and those who received conservative therapy (controls, n=92). Main Outcome Measure: The patients' quality of life was assessed at 6 months, 1 year, and 3 years after undergoing the initial selected treatments for moderate to severe persistent allergic rhinitis. The complications were observed after treatment. Results: Data from 199 of 236 patients who had complete follow-up documents were statistically analyzed. The average posttreatment bilateral endoscopic vidian neurectomy scores of the Rhinoconjunctivitis Quality of Life Questionnaire and visual analog scale were significantly improved at 6 months, 1 year, and 3 years compared with pretreatment scores for group 1 (P<.00) and for those in groups 2 and 3 during the same period. By the patient's self-evaluation posttreatment, the percentages of much improved, improved, and not improved was 64.7% (55 cases), 24.7% (21 cases), and 10.6% (9 cases), respectively. The percentages were significantly higher for those in group 1 than for those in group 2 (P<.05). No severe complication occurred in all 3 patient groups. Conclusion: In the hands of a well-trained surgeon bilateral endoscopic vidian neurectomy is an effective and safe technique in the management of moderate to severe persistent allergic rhinitis.