Cytologic Alterations in Nasal Mucosa after Sphenopalatine Artery Ligation in Patients with Vasomotor Rhinitis

Cassano, Michele; Russo, Luigi; Giudice, Alessandro Maselli Del; Gelardi, Matteo

doi:10.2500/ajra.2012.26.3683

Cited by 13 publications

(14 citation statements)

References 16 publications

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“…Similarly, included CPNN and SPNN studies found significant improvements in the mean scores for rhinorrhea, congestion, itching, sneezing, and quality of life up to 21 months postoperatively. 36–40 Moreover, our findings corroborate and reaffirm the findings of 2 older systematic reviews conducted by Marshak et al (2016) and Halderman et al (2015) who reported comparable efficacy and safety of EVN and PNN in patients with rhinitis (including allergic rhinitis and NAR). 26,42 Uniquely, our findings support the efficacy and safety of the procedures specifically for NAR patients and include studies that performed CPNN.…”

Section: Discussionsupporting

confidence: 90%

Efficacy of Vidian Neurectomy and Posterior Nasal Neurectomy in the Management of Nonallergic Rhinitis: A Systematic Review

Senanayake

Wong

McBride

et al. 2022

Am J Rhinol�Allergy

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Background Nonallergic rhinitis (NAR) is characterized by rhinorrhea, nasal obstruction, and sneezing, in the absence of systemic sensitization to allergens. For cases refractory to medical therapy and conservative surgical interventions, more targeted procedures, such as endoscopic vidian neurectomy (EVN) and posterior nasal neurectomy (PNN), including surgical (SPNN) and cryoablative (CPNN) methods, may reduce symptoms of NAR. Objective The purpose of this study was to compare the efficacy, side effect profile, and complication rate between EVN and PNN for NAR. Methods A systematic review of primary articles that reported original patient data for either EVN or PNN was conducted using Embase, Medline, PubMed, and Cochrane databases since 2006, according to PRISMA guidelines. The primary outcome of the study was an improvement in NAR symptom severity. Secondary outcomes included the incidence of postoperative side effects or complications. Results In total, 58 articles met the search criteria with a total of 9 studies (including 2 RCTs) eligible for inclusion. There was a pooled sample of 229 NAR patients that underwent EVN (n = 65; 28.4%), SPNN (n = 50; 21.8%), or CPNN (n = 114; 49.8%). For all 3 techniques, there was a statistically significant improvement in nasal symptoms, particularly rhinorrhea, nasal congestion, and obstruction along with quality of life. Heterogeneity in outcome reporting prevented meta-analysis and direct comparison of efficacy. The pooled incidence of postoperative complications for EVN (n = 65), SPNN (n = 50), and CPNN (n = 70) was 30.8% versus 0% versus 2.9% for dry eye, 16.9% versus 0% versus 1.4% for palatal/cheek numbness, and 0% versus 6% versus 4.3% for bleeding. Conclusion EVN, SPNN, and CPNN are similarly efficacious for patients with NAR refractory to medical management. SPNN and CPNN are associated with lower rates of complications (dry eye and palatal/cheek numbness) compared with EVN.

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Section: Discussionsupporting

confidence: 90%

Efficacy of Vidian Neurectomy and Posterior Nasal Neurectomy in the Management of Nonallergic Rhinitis: A Systematic Review

Senanayake

Wong

McBride

et al. 2022

Am J Rhinol�Allergy

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“…They generally have a polygonal shape with about 150‐200 cilia at the of top a big central nucleus and a basal region which is in strict contact with basal membrane through desmosomes (Figure , Panel B). A perinuclear halo or hypercromatic supernulcear stria in ciliated cells is a hallmark of normal function, and its reduction has been put in correlation with severity of vasomotor, inflammatory and infectious nasal diseases Muciparous goblet cell: It is a unicellular gland interposed among the respiratory pseudostratified epithelial cells secreting mucin , that in contact with water originates mucus.…”

Section: Cytological Aspects Of Normal Nasal Mucosamentioning

confidence: 99%

Nasal cytology: Methodology with application to clinical practice and research

Heffler

Landi

Caruso

et al. 2018

Clin Experimental Allergy

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Nasal cytology is an easy, cheap, non-invasive and point-of-care method to assess nasal inflammation and disease-specific cellular features. By means of nasal cytology, it is possible to distinguish between different inflammatory patterns that are typically associated with specific diseases (ie, allergic and non-allergic rhinitis). Its use is particularly relevant when other clinical information, such as signs, symptoms, time-course and allergic sensitizations, is not enough to recognize which of the different rhinitis phenotypes is involved; for example, it is only by means of nasal cytology that it is possible to distinguish, among the non-allergic rhinitis, those characterized by eosinophilic (NARES), mast cellular (NARMA), mixed eosinophilic-mast cellular (NARESMA) or neutrophilic (NARNE) inflammation. Despite its clinical usefulness, cheapness, non-invasiveness and easiness, nasal cytology is still underused and this is at least partially due to the fact that, as far as now, there is not a consensus or an official recommendation on its methodological issues. We here review the scientific literature about nasal cytology, giving recommendations on how to perform and interpret nasal cytology.

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“…From these, we selected and have made reference in the text to the following article types: systematic reviews, n = 3; 8 , 15 , 16 narrative reviews or algorithms, n = 8; 11 , 17 – 23 randomised controlled trials, n = 3; 24 – 26 non-randomised controlled studies, n = 4; 1 , 27 – 29 case series or cohort studies, n = 9; 30 – 38 surveys and audits, n = 5; 9 , 10 , 14 , 39 , 40 cost-effectiveness studies, n = 5; 12 , 13 , 41 – 43 anatomy studies, n = 6; 44 – 49 case reports, n = 5; 50 – 54 and historical articles, n = 6 2 7 …”

Section: Resultsmentioning

confidence: 99%

“…Both treatments improved nasal resistance and mucociliary transit times, but with a significantly greater benefit ( p < 0.05) for the latter in the endoscopic sphenopalatine artery ligation group. A highly significant change, beneficial for a hypersecreting nose, was noted in nasal cytology studies following ligation 26 …”

Section: Discussionmentioning

confidence: 98%

“…These authors, in different patients, again produced high-level evidence that dividing the sphenopalatine artery pedicle does something to nasal parasympathetic innervation that, although beneficial in rhinitis, might over-dry a healthy nasal airway 26 . In 30 patients with turbinate hypertrophy due to vasomotor rhinitis, the authors randomised subjects to receive turbinoplasty with and without endoscopic sphenopalatine artery ligation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic sphenopalatine artery ligation for acute idiopathic epistaxis. Do anatomical variation and a limited evidence base raise questions regarding its place in management?

et al. 2017

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Cytologic Alterations in Nasal Mucosa after Sphenopalatine Artery Ligation in Patients with Vasomotor Rhinitis

Abstract: In patients with vasomotor rhinopathy and ITH, improvement in symptoms, nasal resistance, ciliated cell trophism, and MTt was observed after sphenopalatine artery ligation.

Cited by 13 publications

References 16 publications

Efficacy of Vidian Neurectomy and Posterior Nasal Neurectomy in the Management of Nonallergic Rhinitis: A Systematic Review

Efficacy of Vidian Neurectomy and Posterior Nasal Neurectomy in the Management of Nonallergic Rhinitis: A Systematic Review

Nasal cytology: Methodology with application to clinical practice and research

Endoscopic sphenopalatine artery ligation for acute idiopathic epistaxis. Do anatomical variation and a limited evidence base raise questions regarding its place in management?

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