title: Resection of peripheral branches of the posterior nasal nerve compared to conventional posterior neurectomy in severe allergic rhinitis.
abstract: OBJECTIVE
  Transnasal resection of the posterior nasal nerve (TRPN) is the surgical procedure for drug therapy-resistant, intractable allergic rhinitis (AR). Submucous inferior turbinectomy also improves nasal symptoms in severe AR. Surgical injury to this peripheral nerve fibre may be the major cause of the decrease in allergic symptoms. During submucous turbinectomy, we have identified the peripheral branches of the posterior nasal nerve in the inferior turbinate and resected them (SRPN). The aim of this study was to evaluate the therapeutic effects of turbinoplasty with SRPN in severe AR.
  
  
  METHODS
  Improvements in subjective symptoms were compared between 13 patients who underwent SRPN with turbinoplasty (Group 1) and 11 who underwent TRPN combined with turbinoplasty and SRPN (Group 2) by retrospective chart review. Pre- and postoperative sneezing, rhinorrhea, and nasal obstruction were evaluated with questionnaires. Postoperative complications and drug therapy before and after surgery were investigated.
  
  
  RESULTS
  All symptoms improved postoperatively in both groups, with no significant differences in the improvements in nasal symptom scores between the groups.
  
  
  CONCLUSIONS
  SRPN combined with submucosal turbinectomy was shown to be a safe, useful, and efficient approach to patients with AR unresponsive to medical therapy. Although this is a short-term study, the results of this study suggest that SRPN represents one of the treatment options for intractable AR.
authors.affiliation: Department of Otolaryngology, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, Japan. tkobayashi@kochi-u.ac.jp
authors.forename: Taisuke
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Hyodo
authors.forename: Koshiro
authors.initials: K
authors.lastname: Nakamura
authors.forename: Hayato
authors.initials: H
authors.lastname: Komobuchi
authors.forename: Nobumitsu
authors.initials: N
authors.lastname: Honda
mesh_terms: D000328:Adult; D003714:Denervation / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D009297:Nasal Mucosa / Q000294:innervation; D015508:Nasal Obstruction / Q000209:etiology / Q000601:surgery; D059747:Nasal Surgical Procedures / Q000379:methods*; D009666:Nose / Q000294:innervation*; D012189:Retrospective Studies; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000150:complications / Q000601:surgery*; D012912:Sneezing; D016896:Treatment Outcome; D014420:Turbinates / Q000601:surgery*