Posterior nasal nerve neurectomy for the treatment of chronic rhinosinusitis with nasal polyposis: a randomized controlled trial

Eur Arch Otorhinolaryngol. 2023 Apr;280(4):1785-1791. doi: 10.1007/s00405-022-07722-y. Epub 2022 Nov 4.

Abstract

Background: Managing Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP) is always challenging due to the chronicity of the disease and its intractable course. Posterior nasal neurectomy (PNN) can be effective in alleviating symptoms of CRSwNP.

Materials and methods: The study was conducted in a tertiary care referral hospital from August 2019 to April 2022. A total of 46 patients of CRSwNP were included (23 patients in the study and 23 in the control group). Patients in the study group underwent endoscopic sinus surgery (ESS) and PNN and patients in the control group with ESS. The symptoms and quality-of-life improvement were assessed at 1, 4, 12, and 24 weeks after the surgery.

Results: On intragroup analysis between the preoperative and postoperative scores (SNOT-22, RSDI and LK Score), we found a significant difference for each (p < 0.05). When the improvement of outcome scores was compared between the two groups, a significant difference was obtained for SNOT-22 and RSDI scores at 1 week and 4 weeks (p < 0.05). There was no significant difference found for the duration of surgery/complications between the two groups (p = 1.00).

Conclusion: The PNN can be an effective add-on procedure in patients with CRSwNP in alleviating short-term control of the symptoms and the quality of life. A larger sample size with long-term follow-up may be required for a better understanding of the efficacy of the PNN in patients with CRSwNP.

Keywords: Chronic Rhinosinusitis with Nasal Polyposis; Outcomes; Posterior nasal neurectomy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Chronic Disease
  • Denervation
  • Endoscopy / methods
  • Humans
  • Nasal Polyps* / complications
  • Nasal Polyps* / diagnosis
  • Nasal Polyps* / surgery
  • Quality of Life
  • Rhinitis* / complications
  • Rhinitis* / diagnosis
  • Rhinitis* / surgery
  • Sinusitis* / complications
  • Sinusitis* / diagnosis
  • Sinusitis* / surgery
  • Treatment Outcome