Posterior Nasal Nerve Section versus Surface Coblation for Treatment of Intractable Rhinorrhea

Abstract

Background: The severity of the condition and the lifestyle of the patient determine how to treat rhinitis. For patients with either allergic rhinitis or vasomotor (idiopathic) rhinitis, surgical therapy is recommended if symptoms are not adequately controlled by medications. This study aims to examine the outcomes of posterior nasal neurectomy and surface coblation in order to alleviate the symptoms of intractable rhinorrhea.Patients and methods: This prospective non-randomized clinical study included 18 patients above age of 12. Who have intractable rhinorrhea not respond to medical treatment and admitted to ORL-HNS department, Zagazig University. Included patients were classified into two groups; the posterior nasal nerve was excised endoscopically in the first group, while surface coblation was used to cauterize the posterior nasal nerve region in the second group. Results: There was significant improvement in rhinorrhea, sneezing, nasal obstruction, itching, headache , smell and gustatory rhinorrhea after treatment in both group. repeated measures of rhinorrhea, sneezing, nasal obstruction and itching were lower in the pnn section group compared to the surface coblation group but there was no statistically significant difference between both groups regarding repeated assessment for smell , gustatory rhinorrhea and headache.Conclusion: Intractable rhinitis symptoms, especially rhinorrhea and nasal obstruction, can be significantly relieved by either endoscopic resection of the posterior nasal nerve or endoscopic cauterization of the posterior nasal nerve area using surface coblation . The two procedures have the advantage of fewer complications than vidian neurectomy and may spare these patients from their prolonged suffering.