Endoscopic coagulation of sphenopalatine neurovascular bundle for intractable allergic rhinitis: a histopathological study

ABSTRACT

Manifestations of allergic rhinitis are due to a primary immunologic response which leads to a battery of neurovascular reactions. The sphenopalatine foramen [SPF] transmits both the blood and nerve supply to and from the nasal mucosa. We aimed at controlling the allergic reaction by endoscopically coagulating the neurovascular bundle at the SPF. The results were evaluated in patients with intractable allergic rhinitis by comparing the histopathological changes in biopsy specimens from the middle turbinate on the operated sides with control biopsies from the unoperated sides both at 1 month and at 2 years postoperatively. Qualitative and morphometric quantitative histopathological evaluation of the middle turbinate mucosa showed dramatic diminution of the mucosal reactivity and inflammatory cellular infiltrate compared with the control levels at one month postoperatively At 2 years postoperatively, there is a gradual weaning of these effects Endoscopic coagulation of the sphenopalatine neurovascular bundle is a minimally invasive technique that seems promising in controlling intractable allergic rhinitis that fails to respond to medical treatment