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-termresults 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 bilateralendoscopicvidianneurectomy(group1,n=93),those whounderwentpartialinferiorturbinectomyand/orseptoplasty (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 severepersistentallergicrhinitis.Thecomplicationswere observed after treatment. Results: Data from 199 of 236 patients who had completefollow-updocumentswerestatisticallyanalyzed.The average posttreatment bilateral endoscopic vidian neurectomyscoresoftheRhinoconjunctivitisQualityofLife Questionnaire and visual analog scale were significantly improvedat6months,1year,and3yearscomparedwith 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 muchimproved,improved,andnotimprovedwas64.7% (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.