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<p>Allergic rhinitis is a common chronic inflammatory disease that significantly impairs quality of life. Although medical therapy remains the mainstay of treatment, a subset of patients continues to experience persistent symptoms despite optimal management. Endoscopic posterior nasal nerve neurectomy (PNNN) has emerged as a selective surgical option aimed at reducing parasympathetic-mediated nasal symptoms while minimizing complications.&#xa0;To evaluate the clinical effectiveness and safety of endoscopic posterior nasal nerve neurectomy in patients with persistent allergic rhinitis refractory to optimal medical therapy, with emphasis on postoperative symptom improvement and quality of life.&#xa0;This prospective study included 40 adult patients with moderate to severe persistent allergic rhinitis unresponsive to guideline-based medical treatment. All patients underwent endoscopic posterior nasal nerve neurectomy. Nasal symptoms (rhinorrhea, sneezing, nasal itching, and postnasal discharge) and quality of life were assessed using the Japanese Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ) preoperatively and at 1, 3, and 6 months postoperatively. Statistical analysis was performed to compare pre- and postoperative outcomes.&#xa0;There was a statistically significant improvement in all nasal symptoms following surgery (<i>p</i> &lt; 0.001). Mean scores for rhinorrhea, sneezing, nasal itching, and postnasal discharge showed progressive and sustained reduction throughout the follow-up period. Quality of life significantly improved, with the mean JRQLQ score decreasing from 22.4 ± 2.33 preoperatively to 6.2 ± 1.48 at 6 months postoperatively (<i>p</i> &lt; 0.001). No major intraoperative or postoperative complications were recorded, and no cases of dry eye, facial numbness, or significant bleeding were observed.&#xa0;Endoscopic posterior nasal nerve neurectomy is a safe and effective surgical option for patients with persistent allergic rhinitis refractory to medical therapy. The procedure provides significant and sustained improvement in nasal symptoms and quality of life with a favorable safety profile. It should be considered a valuable treatment modality in carefully selected patients with intractable allergic rhinitis.</p>

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Does Endoscopic Posterior Nasal Nerve Neurectomy Improve Symptoms and Quality of Life in Patients With Refractory Allergic Rhinitis?

  • 期刊论文

  • 发表日期：

    2026年5月18日

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  • Amr Embaby Elsayed Karamany,
  • Abdelaziz Mohamed Elsherif,
  • Mohamed Atef Eid,
  • Mohamed Mostafa Zaki,
  • Hesham Mohammed Ismail

摘要

Allergic rhinitis is a common chronic inflammatory disease that significantly impairs quality of life. Although medical therapy remains the mainstay of treatment, a subset of patients continues to experience persistent symptoms despite optimal management. Endoscopic posterior nasal nerve neurectomy (PNNN) has emerged as a selective surgical option aimed at reducing parasympathetic-mediated nasal symptoms while minimizing complications. To evaluate the clinical effectiveness and safety of endoscopic posterior nasal nerve neurectomy in patients with persistent allergic rhinitis refractory to optimal medical therapy, with emphasis on postoperative symptom improvement and quality of life. This prospective study included 40 adult patients with moderate to severe persistent allergic rhinitis unresponsive to guideline-based medical treatment. All patients underwent endoscopic posterior nasal nerve neurectomy. Nasal symptoms (rhinorrhea, sneezing, nasal itching, and postnasal discharge) and quality of life were assessed using the Japanese Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ) preoperatively and at 1, 3, and 6 months postoperatively. Statistical analysis was performed to compare pre- and postoperative outcomes. There was a statistically significant improvement in all nasal symptoms following surgery (p < 0.001). Mean scores for rhinorrhea, sneezing, nasal itching, and postnasal discharge showed progressive and sustained reduction throughout the follow-up period. Quality of life significantly improved, with the mean JRQLQ score decreasing from 22.4 ± 2.33 preoperatively to 6.2 ± 1.48 at 6 months postoperatively (p < 0.001). No major intraoperative or postoperative complications were recorded, and no cases of dry eye, facial numbness, or significant bleeding were observed. Endoscopic posterior nasal nerve neurectomy is a safe and effective surgical option for patients with persistent allergic rhinitis refractory to medical therapy. The procedure provides significant and sustained improvement in nasal symptoms and quality of life with a favorable safety profile. It should be considered a valuable treatment modality in carefully selected patients with intractable allergic rhinitis.