Posterior Nasal Nerve Neurectomy With Mucosal Flap Coverage of the Sphenopalatine Foramen for Treatment of Allergic Rhinitis: 12-Month Outcomes After Treatment in a Prospective Cohort Study.

IF 2.3 3区 医学 Q1 OTORHINOLARYNGOLOGY
Linlu Wang, Huiyi Deng, Qintai Yang, Shuo Wu
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Abstract

ObjectivesPosterior nasal nerve (PNN) neurectomy is an effective surgical option for refractory allergic rhinitis (AR), but delayed massive hemorrhage remains a concern. This study aimed to evaluate whether preserving a mucosal flap to cover the sphenopalatine foramen (SPF) affects postoperative efficacy and complications.MethodsThis prospective cohort study included 61 patients with moderate-to-severe AR who underwent PNN neurectomy. Patients were divided into two groups based on whether a mucosal flap was preserved to cover the SPF. Outcomes included mucosal epithelialization time, incidence of delayed bleeding, Visual Analog Scale (VAS), reflective Total Nasal Symptom Score (rTNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), nasal airway resistance (NAR), and inflammatory markers. Follow-up was conducted at 1, 3, 6, and 12 months postoperatively.ResultsNo significant differences were found between groups in baseline characteristics. Both groups showed significant improvements in VAS, rTNSS, RQLQ, and NAR, with sustained benefits up to 12 months. The With Mucosal Flap Preservation group had a significantly shorter epithelialization time (P < .001) and lower incidence of delayed bleeding (P = .046). Mediation analysis indicated that epithelialization time mediated the relationship between the surgical method and delayed bleeding (P = .046), while the direct effect was not significant (P = .748).ConclusionThis study shows that PNN neurectomy with mucosal flap preservation reduces the risk of delayed postoperative bleeding through the key mediating mechanism of accelerated mucosal epithelialization, while achieving comparable improvements in nasal symptom relief and quality of life compared to the procedure without mucosal flap preservation.

鼻后神经切除术伴蝶腭孔粘膜瓣覆盖治疗变应性鼻炎:一项前瞻性队列研究治疗后12个月的结果
目的鼻后神经(PNN)神经切除术是治疗难治性变应性鼻炎(AR)的有效手术选择,但延迟性大出血仍然是一个问题。本研究旨在评估保留黏膜瓣覆盖蝶腭孔(SPF)是否影响术后疗效和并发症。方法本前瞻性队列研究纳入61例接受PNN神经切除术的中重度AR患者。根据是否保留粘膜瓣覆盖SPF将患者分为两组。结果包括粘膜上皮化时间、延迟出血发生率、视觉模拟量表(VAS)、反射性鼻症状总评分(rTNSS)、鼻结膜炎生活质量问卷(RQLQ)、鼻气道阻力(NAR)和炎症标志物。术后1、3、6、12个月随访。结果两组患者基线特征无显著差异。两组VAS、rTNSS、RQLQ和NAR均有显著改善,且持续获益达12个月。保留黏膜瓣组上皮化时间明显缩短(P = 0.046)。中介分析表明,上皮化时间介导了手术方式与延迟出血的关系(P =。046),而直接影响不显著(P = .748)。结论本研究表明,PNN神经切除术保留粘膜瓣通过加速粘膜上皮化的关键中介机制降低了术后延迟出血的风险,同时与不保留粘膜瓣的手术相比,在鼻症状缓解和生活质量方面取得了相当的改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.60
自引率
11.50%
发文量
82
审稿时长
4-8 weeks
期刊介绍: The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.
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