Long-term Results of Bilateral Endoscopic Vidian Neurectomy in the Management of Moderate to Severe Persistent Allergic Rhinitis

Objective

To evaluate the long-term efficacy of bilateral endoscopic vidian neurectomy in the management of moderate to severe persistent allergic rhinitis.

Design

A prospective reassessment of the postoperative long-term results of bilateral endoscopic vidian neurectomy using the Rhinoconjunctivitis Quality of Life Questionnaire and visual analog scale for patients with moderate to severe persistent allergic rhinitis.

Setting

University hospital.

Patients

A total of 236 patients with moderate to severe persistent allergic rhinitis were divided into the following 3 treatment groups: those who underwent bilateral endoscopic vidian neurectomy (group 1, n = 93), those who underwent partial inferior turbinectomy and/or septoplasty (group 2, n = 51), and those who received conservative therapy (controls, n = 92).

Main Outcome Measure

The patients' quality of life was assessed at 6 months, 1 year, and 3 years after undergoing the initial selected treatments for moderate to severe persistent allergic rhinitis. The complications were observed after treatment.

Results

Data from 199 of 236 patients who had complete follow-up documents were statistically analyzed. The average posttreatment bilateral endoscopic vidian neurectomy scores of the Rhinoconjunctivitis Quality of Life Questionnaire and visual analog scale were significantly improved at 6 months, 1 year, and 3 years compared with pretreatment scores for group 1 (P < .00) and for those in groups 2 and 3 during the same period. By the patient's self-evaluation posttreatment, the percentages of much improved, improved, and not improved was 64.7% (55 cases), 24.7% (21 cases), and 10.6% (9 cases), respectively. The percentages were significantly higher for those in group 1 than for those in group 2 (P < .05). No severe complication occurred in all 3 patient groups.

Conclusion

In the hands of a well-trained surgeon bilateral endoscopic vidian neurectomy is an effective and safe technique in the management of moderate to severe persistent allergic rhinitis.