Application of posterior nasal neurotomy in the clinical treatment of recurrent sinusitis with polyps / 中国内镜杂志

ABSTRACT

Objective To analyze the clinical efficacy of functional endoscopic surgery combined with posterior nasal neurotomy in the treatment of recurrent sinusitis with polyps and its impact on important inflammatory indicators,and explore its clinical mechanism of action.Method 54 patients with recurrent sinusitis and polyps who visited our hospital from January to December 2021 were selected and randomly divided into an experimental group(27 cases)and a control group(27 cases).The control group underwent functional endoscopic sinus surgery,while the experimental group underwent functional endoscopic surgery combined with posterior nasal neurotomy.The total effective rate at preoperative,postoperative 6 and 12 months,sino-nasal outcome test-22(SNOT-22)score,Lund-Kennedy score of the nasal endoscopy,and changes in important inflammatory factors[eosinophil(EOS),immunoglobulin E(IgE),interleukin-4(IL-4),interleukin-5(IL-5)]were compared.Results There was no statistically significant difference in the observation indicators between the two groups of patients before surgery.The number of follow-up patients in the experimental group at 6 and 12 months after surgery was 25 and 23,respectively.The number of follow-up patients in the control group at 6 and 12 months after surgery was 26 and 25,respectively.All postoperative observation indicators was significantly improved compared to before surgery;The total effective rate,SNOT-22 score,and Lund-Kennedy score of the nasal endoscopy in the experimental group were better than those in the control group at 6 and 12 months after surgery,and the levels of EOS,IgE,IL-4,and IL-5 in the experimental group were significantly lower than those in the control group at 12 months after surgery,the differences were statistically significant(P<0.05).Conclusion For patients with recurrent sinusitis and polyps,functional endoscopic surgery combined with posterior nasal neurotomy can better inhibit IgE secretion and mucosal inflammatory response,and improve the postoperative treatment effect.