Effect of posterior nasal neurectomy on the suppression of allergic rhinitis

Objectives: Recent guidelines have revealed that allergic rhinitis (AR) impairs quality of life. Neuropeptides play a central role in AR. The aim of this study was to determine the efficacy of posterior nasal neurectomy (PNN) for the treatment of AR and for the suppression of neuropeptides and type 2 cytokine expression. Methods: In total, 77 patients undergoing PNN were recruited. Subjective symptoms, including sneezing and rhinorrhea, were elicited with a questionnaire using a 10 cm visual analogue scale (VAS). Nasal lavage fluid taken from a random sample of 17 patients both preoperatively and 1 year postoperatively was screened with enzyme-linked immunosorbent assays. Results: Postoperative rhinorrhea (6.03 +/- 1.31 vs 2.12 +/- 1.40, P < 0.001) and sneezing (5.53 +/- 1.25vs 2.04 +/- 1.29, P < 0.001) were significantly improved relative to the preoperative levels; the mean SP and NPY concentrations in the nasal lavage fluid were 91.6 +/- 20.9 pg/ml and 71.5 +/- 10.5 pg/ml, which decreased significantly to 52.9 +/- 16.7 pg/ml and 31.8 +/- 8.2 pg/ml, respectively, and the mean periostin and IL-5 concentrations were 215.2 +/- 87.7 pg/ml and 984.5 +/- 181.8 pg/ml, which decreased significantly to 146.1 +/- 70.1 pg/ml and 281.6 +/- 74.0 pg/ml, respectively. Conclusions: PNN was safe and well tolerated, and the symptom (sneezing and rhinorrhea) scores were significantly decreased by 1 year postoperatively.