Abstract：【Objective】To investigate the effect of one side vidian neurectomy combined with selective vidian neurectomy on the side in the treatment of allergic rhinitis and its influence on tear secretion.【Methods】A total of forty-four patients with allergic rhinitis were treated with vidian neurectomy on one side and selective vidian neurectomy on the other side. Nasal symptom visual analogue scale and test Schirmer I were compared before and after surgery to observe the treatment effect and complications. 【Results】Among the 44 patients, 27 cases (61.4%) were markedly effective, 16 cases (36.3%) were effective, and 1 case (2.3%) was ineffective. The overall effective rate was 97.7% (43/44). Postoperative scores of VAS at the time of 6 and 12 months were lower than preoperative scores and the difference was statistically significant (P<0.05). On the 5th day, 1 month, and 3 months after surgery, the average level of tear secretion in the left eye was lower than that before surgery (P<0.05). On the 5th day and 1 month after surgery, the average level of tear secretion in the right eye was lower than that before surgery, the difference was statistically significant (P<0.05). Three months after operation, there was no significant difference in the average level of right tear secretion compared with that before operation (P>0.05). On the 5th day after operation, 1 month and 3 months after operation, the average level of left tear secretion was significantly lower than that of the right eye, and the differences were all significant (P<0.05).【Conclusion】Endoscopic vidian neurectomy combined with Elective vidian neurectomy has a good short-term effect in the treatment of allergic rhinitis, and has little effect on postoperative tear secretion.
李湘胜, 梁丹, 刘甜, 谢东海, 宋桂林. 翼管神经主干切断术联合分支切断治疗变应性鼻炎的疗效观察[J]. 医学临床研究, 2022, 39(1): 30-32.
LI Xiang-sheng, LIANG Dan, LIU Tian, et al. Effect of One Side Vidian Neurectomy Combined with Another Side Selective Vidian Neurectomy in Treatment of Allergic Rhinitis. JOURNAL OF CLINICAL RESEARCH, 2022, 39(1): 30-32.
[1] WANG XD, ZHENG M, LOU HF, et al. An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005 to 2011[J].Allergy,2016,71(8):1170-1180.
[2] 齐岩,刘俊其,彭舒娅,等. 鼻内镜下选择性翼管神经切断术对伴有变应性鼻炎的慢性鼻窦炎的疗效观察[J].山东大学耳鼻喉眼学报,2019,33(1):109-113.
[3] BOUSQUET P J, BACHERT C, CANONICA G W, et al. Uncontrolled allergic rhinitis during treatment and its impact on quality of life: a cluster randomized trial[J].J Allergy Clin Immunol,2010,126(3):666-668.
[4] 何光耀, 谢貌, 牛志杰,等. 难治性变应性鼻炎手术治疗的进展[J].微创医学,2019,14(5):631-634.
[5] MAIMAITIALI G, KAHAER K, TANG L, et al. The effect of vidian neurectomy on pulmonary function in patients with allergic rhinitis and chronic rhinosinusitis with nasal polyps[J].Am J Med Sci,2020,360(2):137-145.
[6] JOHNSON M E, MUMHY P J. Changes in the tear film and ocular surface from dry eye syndrome[J].Prog Retin Eye Res,2004,23(4):449-474.
[7] 谭国林. 难治性变应性鼻炎的外科治疗现状[J].医学临床研究,2021,38(3):321-325.
[8] WANG E W, GARDNER P A, FRASER S, et al. Reduced tearing with stable quality of life after vidian neurectomy: a prospective controlled trial[J].Laryngoscope,2021, 131(7):1487-1491.
[9] 冀永进,张艳廷,赵长青,等. 鼻内镜下经蝶窦翼管神经切断术的手术探讨[J].中国耳鼻咽喉颅底外科杂志,2014,20(6): 483-486.
[10] ALBS S, TRMBITAS V, NAGY A. Endoscopic microdebrider-assisted inferior turbinoplasty with and without posterior nasal neurectomy[J].Auris Nasus Larynx,2014,41(3):273-277.
[11] 王艳杰, 安云芳, 赵长青,等. 鼻内镜下单侧翼管神经切断术对变应性鼻炎合并哮喘的疗效观察[J].中国耳鼻咽喉颅底外科杂志,2020,26(02): 171-175.
2022, Vol. 39 
