DOI: 10.12688/f1000research.176101.1 ISSN: 2046-1402

A Comparative Study of Posterior Nasal Nerve Resection and Surface Coablation in the Management of Allergic Rhinitis

Mustafa A. Husein, Haider Ibrahim, Salahaldeen Hosni
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Background Allergic rhinitis (AR) is a common chronic inflammatory illness of the nasal mucosa that affects quality of life, even if medicine is the first-line treatment. Most moderate to severe persistent AR patients’ symptoms is unsatisfactory despite attempting medication. Modern surgery targets the posterior nasal nerve. This study compared the benefits and safety of surface coablation and posterior nasal nerve resection (PNNR) for persistent allergic rhinitis. Methods In a prospective comparison research, 54 patients (27 per group) aged 18–60 were diagnosed with moderate and severe chronic AR according to ARIA recommendations. One group got endoscopic PNN resection and the other underwent surface coablation. The Total Nasal Symptom Score (TNSS) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) assessed baseline and 2-, 6-, and 10-months postoperative outcomes. Results Both therapies significantly reduced TNSS and RQLQ scores from baseline. An improvement of 67–92 percent at 2 months and 46–49 percent at 10 months was seen and sustained. Increasing exercise, sleep, and emotional well-being improved RQLQ scores by 100% at 2 months and > 75% at 10 months. Crustations (11% in PNNR vs. 48% in coablation) and light bleeding (4%) were other minor issues. There were no major issues. Conclusion Posterior nasal nerve excision and surface coablation are safe and efficacious for refractory allergic rhinitis. Surface coablation recovers faster, but posterior nasal nerve resection is more stable and has less problems. These findings suggest both methods can treat persistent allergic rhinitis refractory to medical treatment.

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