Submucosal Turbinectomy with Posterior-Superior Nasal Neurectomy for Patients with Allergic Rhinitis.

Kawamura, Shigeki; Asako, Mikiya; Momotani, Akiyo; Kedai, Hiroki; Kubo, Nobuo; Yamashita, Toshio

doi:10.5631/jibirin.93.367

Cited by 20 publications

(13 citation statements)

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“…However, it has a risk of causing bleeding and ophthalmoplegia, and there are sometimes difficulties in finding the nerve [11]. To resolve these problems, we developed a new, innovative surgical modality to advance vidian neurectomy [12].…”

Section: Introductionmentioning

confidence: 99%

Functional inferior turbinosurgery (FITS) for the treatment of resistant chronic rhinitis

Ikeda

Oshima²,

Suzuki

et al. 2006

Acta Oto-Laryngologica

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The patients showed a remarkable improvement of > or = 80%, with the exception of two patients who had an approximately 50% reduction of the total symptomatic scores. Four of eight patients with anosmia subjectively improved whereas the other four patients felt unchanged. All patients who underwent rhinomanometry (n=15) and nasal provocation testing (n = 15) both before and after surgery showed a significant improvement. There were no intraoperative complications. Postoperative epistaxis occurred in one patient. One patient complained of a transient hypesthesia of the soft palate and dry eye. Nasal mucosal tears were observed in approximately 30% of the patients who otherwise showed no severe synechia or persistent crusting.

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Section: Introductionmentioning

confidence: 99%

Functional inferior turbinosurgery (FITS) for the treatment of resistant chronic rhinitis

Ikeda

Oshima²,

Suzuki

et al. 2006

Acta Oto-Laryngologica

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“…Kawamura et al [10] performed posterior nasal neurectomy using a harmonic scalpel in 20 intractable AR patients, and reported subjective improvement of sneezing, nasal discharge, and nasal obstruction in 90%, 75%, and 100% of the patients, respectively. Ikeda et al [22] used a microdebrider‐assisted technique for submucosal and stromal ablation of the inferior turbinates and named a series of the combined procedure as functional inferior turbinosurgery.…”

Section: Clinical Effectiveness Of Posterior Nasal Neurectomymentioning

confidence: 99%

“…AR can be pathologically defined as an unregulated inflammatory condition of the nose, characterized by increased accumulation of activated inflammatory cells. The common histological observation after laser surgery is scar tissue formation in the submucosal layer with subsequent shrinkage of the turbinate, which is preferable for interruption of allergic reactions [9, 10]. Inouye et al [11] reported that squamatization of the nasal epithelium increases the physiological barriers against invading foreign allergens.…”

Section: Modifications Of Local Allergic Condition By Laser Surgerymentioning

confidence: 99%

“…Indeed, it is an issue of debate as to whether submucous turbinectomy alone is enough for treating severe AR patients, because the turbinate mucosa plays an essential role in IgE‐mediated allergic reactions. Recently, several combined surgical procedures have been proposed physically or functionally to eliminate the effector organ of the inferior turbinate [10, 22].…”

Section: Surgical Approaches To Hypertrophic Inferior Turbinatesmentioning

confidence: 99%

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Surgical treatment of the inferior turbinate for allergic rhinitis: clinical evaluation and therapeutic mechanisms of the different techniques

et al. 2009

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Summary Many different surgical procedures have been described to alleviate nasal obstruction due to turbinate hypertrophy in patients with allergic rhinitis (AR) who continuously have chronic nasal congestion. The goal of surgical procedures should be ‘optimal reduction of volume and secretion with preservation of function’. For a period of about 25 years, laser surgery of the inferior turbinate has been considered a simple and effective surgical treatment with a low complication rate that has been in widespread use by many ENT surgeons. Various trials have demonstrated the clinical effectiveness of a series of different laser systems including carbon dioxide, Nd:YAG, potassium‐titanyl‐phosphate, and diode laser. Laser surgery generally induces significant increases of the total volume of the nasal cavity. Several studies have provided evidence that the expression degree of local inflammatory cytokines and chemical mediators can be attenuated by the treatment. The mucociliary function of the inferior turbinate seems to be preserved after CO2 laser intervention. A breakthrough in the surgical procedures available for allergic patients who severely suffer from both intractable hypertrophic inferior turbinates and unregulated nasal secretion was introduced in Japan. Posterior nasal neurectomy is a novel alternative method in which neural bundles are selectively cut or cauterized from the sphenopalatine foramen. Resection of the posterior nasal nerve at this point enables surgeons to inhibit the parasympathetic nerve function of the nasal mucosa with no troublesome complications such as decrease of lacrimal secretion. The procedure simultaneously provides interruption of the somatic afferent innervation to the turbinate mucosa. Herein we assess the clinical effectiveness of this surgical procedure based on objective and measurable monitoring parameters and discuss the underlying therapeutic mechanisms.

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“…They concluded that selective resection of peripheral branches of the posterior nerve could reduce allergic symptoms. Kawamura et al 24 , in their study of PNN with harmonic scalpel among 20 patients, observed subjective improvement in nasal obstruction, sneezing and nasal discharge in 100%, 90% and 75% patients respectively. They reported no surgical complications.…”

mentioning

confidence: 99%

Original study. Effectiveness of endoscopic posterior nasal neurectomy for the treatment of intractable rhinitis

Arun

Moideen

Mohan

et al. 2017

Romanian Journal of Rhinology

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Effectiveness of endoscopic posterior nasal neurectomy for the treatment of intractable rhinitis INTRODUCTIONRhinitis is an inflammatory condition affecting the lining of the nose, characterized by nasal congestion, rhinorrhea, itching, sneezing and/or post-nasal discharge 1 . More than 20% of the population is affected by chronic rhinitis [2][3][4] . Depending on whether an allergic etiology is implicated, non-infectious rhinitis can be subdivided into allergic and non-allergic. With 600 million of world's population affected, allergic rhinitis is the most prevalent atopic disorder. The incidence of allergic rhinitis is on steady increase 5 . Various etiological factors have been postulated for chronic rhinitis -these include allergy, occupational exposures, hormonal changes, smoking, xylometazoline abuse, etc. The standard treatment strategy is medical (histamine antagonists, leukotriene receptor antagonists, intranasal corticosteroids, etc.) But many times, these therapies show limited effectiveness and cause substantial burden for treatment cost on the long term. In addition, the symptoms of intractable rhinitis can cause social embarrassment with a profound effect on patients' quality of life.Surgical management can be considered in such patients with intractable rhinitis. Various surgical techniques have been documented including Vidian neurectomy 6 , posterior nasal neurectomy, inferior turbinate reduction, with varying success rates [5][6][7][8] . In view of this, we are studying the effectiveness of posterior nasal neurectomy (PNN) in patients who have intractable rhinitis, refractory to maximum medical therapy. The outcome is assessed with patient's level of satisfac-ABSTRACT BACKGROUND. Chronic rhinitis is a clinical condition affecting more than 20% of the world population. The standard treat-

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Submucosal Turbinectomy with Posterior-Superior Nasal Neurectomy for Patients with Allergic Rhinitis.

Cited by 20 publications

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Functional inferior turbinosurgery (FITS) for the treatment of resistant chronic rhinitis

Functional inferior turbinosurgery (FITS) for the treatment of resistant chronic rhinitis

Surgical treatment of the inferior turbinate for allergic rhinitis: clinical evaluation and therapeutic mechanisms of the different techniques

Original study. Effectiveness of endoscopic posterior nasal neurectomy for the treatment of intractable rhinitis

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