The Clinical Efficacy and Safety of Endoscopic Vidian-Branch Neurectomy in Intractable Allergic Rhinitis.

Objective: Intractable allergic rhinitis (iAR) remains a clinical challenge. This study aims to evaluate the efficacy and safety of endoscopic selective vidian branch neurectomy for iAR.

Study design: A prospective clinical study.

Setting: A tertiary referral center.

Methods: A total of 205 iAR patients were initially recruited and divided into 3 groups: endoscopic vidian-branch neurectomy (EVBN), endoscopic vidian neurectomy (EVN), and conservative treatment (control). All patients were followed up for more than 2 years, and the efficacy and postoperative complications were compared.

Results: After 2-year follow-up, a total of 195 patients were included, with 59 patients in EVBN group, 71 in EVN group, and 64 in control group. Post-treatment assessments at 6 months, 1 year, and 2 years revealed significant reductions in the total Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores and each domain in both EVBN and EVN groups compared to their baseline levels. However, no significant changes were observed in control group. Furthermore, the improvements in RQLQ 2 years post-treatment were higher in EVBN and EVN groups compared to control group. In EVBN group, only 3 (5.1%) patients reported mild eye dryness during the first month postoperation. However, in the EVN group, 15 (21.1%) patients experienced eye dryness, with 6 (8.5%) cases persisting for more than 1 year and remaining unresolved by the end of the 2-year follow-up.

Conclusion: Both EVBN and EVN were effective in iAR patients. However, EVBN appears to be a safer option, associated with fewer postoperative complications.