Posterior Nasal Nerve Section versus Surface Coblation for treatment of intractable Rhinorrhea.

Background:Intractable rhinitis either due to allergic rhinitis or vasomotor rhinitis could affect patient lifestyle and quality of lifesurgical 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(PNN) was excised endoscopically in the first group, while surface coblation was used to ablatethe posterior nasal nerve region in the second group. Results: There was significant improvement in rhinorrhea, sneezing, nasal obstruction, itching, smell and gustatory rhinorrhea after treatment in both group. Repeated measures of rhinorrhea, sneezing, nasal obstruction and itchingwere 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 and gustatory rhinorrhea. Conclusion:Intractable rhinitis symptoms, especially rhinorrhea, sneezing and nasal obstruction, can be significantly relieved by either endoscopic resection of the posterior nasal nerve or endoscopic ablation of the posterior nasal nerve area using surface coblation. Although symptoms of both groups improved, the post-operative results of PNN section were better than surface coblation but the technique of surface coblation is simpler, safer and time saver. [ABSTRACT FROM AUTHOR]