Sphenopalatine artery ligation with nerve resection in patients with vasomotor rhinitis and polyposis: a prospective, randomized, double-blind investigation

Acta Otolaryngol. 2012 May;132(5):525-32. doi: 10.3109/00016489.2011.648272. Epub 2012 Feb 16.

Abstract

Conclusions: Sphenopalatine artery ligation relieves symptoms of rhinorrhea, sneezing, and nasal itching in patients with vasomotor rhinitis associated with nasal polyps.

Objectives: Nasal polyps often arise in a setting of vasomotor rhinitis. Dysfunctions in nerve fiber activity of the sympathetic and parasympathetic systems are responsible for the accompanying symptoms of rhinorrhea, sneezing, and nasal itching. Sphenopalatine pedicle resection with autonomic denervation could potentially reduce related symptoms.

Methods: In a prospective, double-blind setting, 60 patients with vasomotor rhinitis and bilateral nasal polyps randomly assigned to functional endoscopic surgery either with (group A) or without (group B) sphenopalatine artery ligation completed a 3-year follow-up. Preoperative and postoperative (at 1 and 3 years) evaluations included symptom score, fiberendoscopy, and active anterior rhinomanometry.

Results: In both treatment groups nasal breathing had improved at 1-year and 3-year follow-up (p < 0.001), whereas an improvement in rhinorrhea (p < 0.001) and sneezing and itching (p < 0.01) was attained only in group A. The inter-group comparison showed that a statistically significant improvement in rhinorrhea and nasal itching (p = 0.002) and in sneezing (p < 0.001) was present in group A at both follow-up visits. Rhinomanometry improved in both treatment groups (p < 0.01). Inter-group comparison showed a significant difference only at the 3-year follow-up visit (p < 0.05).

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Double-Blind Method
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Ligation
  • Male
  • Middle Aged
  • Nasal Polyps / complications
  • Nasal Polyps / diagnosis
  • Nasal Polyps / surgery*
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Palate / blood supply*
  • Prospective Studies
  • Rhinitis, Vasomotor / diagnosis
  • Rhinitis, Vasomotor / etiology
  • Rhinitis, Vasomotor / surgery*
  • Rhinomanometry
  • Sphenoid Sinus / blood supply*
  • Treatment Outcome
  • Vascular Surgical Procedures / methods*
  • Young Adult