Diode laser posterior nasal neurectomy with or without partial posterior turbinectomy in patients with intractable vasomotor rhinitis: a prospective comparative study

TL;DR

This study compares two laser surgery techniques for treating severe vasomotor rhinitis, finding that combining procedures improves symptoms like nasal obstruction and rhinorrhea.

Contribution

The study introduces a comparative analysis of diode laser posterior nasal neurectomy with and without turbinectomy for vasomotor rhinitis.

Findings

Group A (LPNT) showed highly significant improvement in rhinorrhea and obstruction (P < 0.0001) at 6 months.

Group B (LPN) showed significant improvement in rhinorrhea and obstruction (P < 0.05) at 6 months.

Group A had significantly better results than Group B in reducing nasal irritation symptoms (P < 0.05).

Abstract

To assess and compare the surgical outcomes of the diode laser posterior nasal neurectomy with or without posterior turbinectomy in patients with refractory vasomotor rhinitis, regarding rhinorrhea, obstruction and irritation symptoms.

The study group (32 patients) was distributed into two equal groups: Group A, diode laser posterior nasal neurectomy with posterior turbinectomy group (LPNT), and Group B, diode laser posterior nasal neurectomy only (LPN). In DLT, the machine was in continuous mode with intermittent loading, with the laser energy level set to 6 W.

In the 6th month, in group A, there was a highly significant difference (in comparison to preoperative data) regarding rhinorrhea and nasal obstruction (P < 0.0001). In group B, a significant difference between the pre- and postoperative findings regarding rhinorrhea and nasal obstruction (P < 0.05) were reported. Regarding rhinorrhea and nasal obstruction, a highly significant difference between the two groups was reported. On comparison of postoperative data of both groups, a significant difference was reported regarding nasal irritation symptoms (P < 0.05). Methylene blue saccharine test was applied to test the mucociliary clearance system objectively; the mean of both groups (in the 6th month) showed a statistically significant difference with a tendency towards group B. The Visual Analog Score showed significant improvements in both groups.

Laser ablation of the posterior nasal nerve has proved to be a reliable, safe, and efficient technique. The combination of laser posterior nasal neurectomy and conservative posterior turbinectomy allowed the reduction of nasal hyperreactivity and improved the annoying symptoms of refractory rhinorrhea.

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