Study on the Efficacy of Vidian Neurectomy in Combined Ocular‐Nasal Therapy for Allergic Rhinoconjunctivitis
Chao Hu, Gengsheng Liu, Chuang Li, Renbin Guo, Kun Wu, Yanhui DingAbstract
Objective
To evaluate the efficacy of vidian neurectomy (VN) in improving nasal and ocular symptoms in patients with drug‐refractory allergic rhinoconjunctivitis (ARC).
Study design
A prospective randomized controlled study.
Setting
Yiyang Central Hospital.
Methods
A total of 220 patients with drug‐refractory ARC were allocated to the VN (n = 110) and fluticasone propionate (FP) (n = 110) groups. Clinical data, serum, and tear samples were collected at baseline and at 1 week, 2 weeks, 1 month, and 3 months after treatment. Serum immunoglobulin E (IgE), IgG, and IgA levels, tear meniscus height (TMH), tear break‐up time (TBUT), tear secretion (via Schirmer's test [SIT]), and eosinophil cationic protein (ECP) and histamine (HA) were assessed. A 1‐year follow‐up was conducted to evaluate complications and recurrence, and the Kaplan‐Meier curves were plotted to show the recurrence rates.
Results
Following treatment, patients in the VN group showed reduced serum IgE, IgG, IgA, ECP, and HA levels, and Visual Analog Scale (VAS), Sino‐Nasal Outcome Test‐20, Total Nasal Symptom Score, corneal fluorescein staining, and Rhinoconjunctivitis Quality of Life Questionnaire scores, and increased TMH, TBUT, and SIT. Both groups demonstrated symptom relief (reduced VAS scores); however, the VN group achieved greater and more sustained improvement, particularly at 3 months, whereas the FP group plateaued after 1 month. Although complications were more frequent in the VN group, the 1‐year recurrence rate was lower.
Conclusion
VN significantly improves nasal and ocular symptoms, reduces immunologic and inflammatory markers, and lowers short‐term recurrence in drug‐refractory ARC, indicating favorable clinical potential.