Three-Year Outcomes After Posterior Nasal Neurectomy in Perennial Moderate and Severe Allergic Rhinitis Patients

Background Posterior nasal neurectomy (PNN) has been shown to reduce the symptom burden of patients with perennial moderate and severe allergic rhinitis (AR). Objectives To evaluate the long-term safety and effectiveness of PNN for the treatment of perennial moderate and severe AR. Methods A prospective 3-year single-arm study was conducted in which the reflective total nasal symptom score (rTNSS) and total non-nasal symptom score (rTNNSS) were collected preoperatively and at 3 months, 6 months, 1 year, 2 years, and 3 years postoperatively. Results A total of 213 patients with AR were recruited and received PNN, of whom 154 patients completed the 3-year follow-up. The mean rTNSS of the long-term follow-up patients improved from 7.74 (95% confidence interval CI 7.507-7.974) at baseline to 2.604 (95% CI 2.221-2.986), P < .001, at 6 months and showed sustained improvement to 3.156 (95% CI 2.806-3.506), P < .001, at 3 years. The mean rTNNSS ranged from 1.301 (95% CI 1.112-1.491) at baseline to 0.564 (95% CI 0.441-0.688) ( P < .001) at 6 months and showed sustained improvement to 0.641 (95% CI 0.533-0.749) ( P < .001) at 3 years. The rTNSS subscores (sneezing, congestion, rhinorrhea, and itching) and rTNNSS subscores (lacrimation, eye itching, postnasal drip, and cough) remained significantly improved from the baseline at all follow-up time points (all P < .001). Conclusion Posterior nasal neurectomy significantly and sustainably alleviated nasal and non-nasal symptoms of perennial moderate and severe AR and improved patient quality of life through 3 years postprocedure.