Mid-term efficacy of endoscopic posterior nasal nerve neurectomy combined with functional endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps: a multicenter randomized controlled Trial

Background The Mid-term efficacy of endoscopic posterior nasal nerve neurectomy (PNN) combined with functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) is a question.Aims/Objectives To evaluate the Mid-term efficacy and safety of PNN + FESS.Material and Methods This was a multicenter, randomized, controlled, assessor-blinded trial. 60 patients were randomly assigned to PNN + FESS group (n = 30) or the FESS group (n = 30). The primary outcome measures were the VAS, Total Nasal Symptom Score (TNSS), and SNOT-22 scores assessed at baseline and at 3, 6, and 12 months postoperatively. Secondary outcomes included changes in serum levels of IL-4 and IL-5.Results At 12 months, symptom scores in both groups showed significant improvement from baseline (p < 0.001). Intergroup comparisons revealed that the experimental group demonstrated significantly greater TNSS improvement at all time points (p < 0.05). The improvement in SNOT-22 score in the experimental group was also significantly greater at 12 months (p < 0.05). Both groups exhibited a decrease in serum IL-4 and IL-5 levels.Conclusions and Significance Combined PNN and FESS provides sustained medium-term improvements in nasal symptoms and quality of life for patients with CRSwNP, showing superior efficacy compared to FESS alone.