Article reprinted from: Medical Innovation Science
Although this disease does not usually bring fatal danger to patients, if allergic rhinitis is not treated in time, it is very likely to be complicated by oozing Otitis media, and even bronchial asthma, affect the normal life and work of patients.
Therefore, many patients with allergic rhinitis, especially moderate to severe persistent allergic rhinitis, will actively seek treatment.
At present, the principle of treatment for allergic rhinitis is to avoid allergen exposure as much as possible, rational use of antihistamines, glucocorticoids and other drugs to prevent and control symptoms, and specific immunotherapy can be used for patients with conditions.
However, for some patients, the use of drugs is very limited. So, what should these patients do?
In fact, in addition to drugs, allergic rhinitis can also be treated by surgery, which also brings new hope to patients with allergic rhinitis who are ineffective in drug treatment.
The surgical methods for allergic rhinitis are mainly divided into two categories, one is to expand the nasal cavity to relieve the symptoms of nasal congestion; the other is to cut off the nerves related to the symptoms of allergic rhinitis to relieve the flow. Symptoms of runny nose, itchy nose, and sneezing.
Nasal cavity expansion
The methods of nasal cavity expansion mainly include inferior nasal septum deviation correction and inferior turbinoplasty.
Since the abnormal shape of the nasal cavity usually leads to nasal congestion, allergic rhinitis can also cause nasal congestion. The combination of these two factors will make the symptoms of nasal congestion worse. If the patient also has nasal congestion symptoms when allergic rhinitis does not occur, nasal cavity expansion can be selected.
At present, general anesthesia is usually used for deviated septum correction, while general anesthesia or local anesthesia can be selected for inferior turbinoplasty.
Method of cutting nerves related to allergic rhinitis symptoms
The method of cutting nerves related to allergic rhinitis symptoms is mainly pterygotomy.
This operation is to directly cut off the pterygoid nerves associated with the runny nose, itchy nose, and sneezing in patients with allergic rhinitis, thereby relieving the symptoms of allergic rhinitis.
However, due to the direct severing of the pterygoid nerve in this number of operations, some patients may have complications of stubborn dry eye after surgery. Currently, highly selective posterior nasal nerve transection is generally chosen to replace this operation.
Highly selective posterior nasal nervectomy can only cut off the posterior nasal nerves innervating the nasal mucosa on the basis of protecting the nerves innervating the lacrimal glands in the pterygoid nerve, so as to avoid the occurrence of dry eye. Since cutting the posterior nasal nerve is equivalent to cutting off most of the autonomic and sensory nerve fibers distributed to the nasal cavity, highly selective posterior nasal nerve cutting can reduce the high sensitivity of the nasal cavity and relieve the symptoms of allergic rhinitis.
Who is suitable for surgical treatment of allergic rhinitis?
Conservative medical treatment or desensitization treatment is ineffective, and the symptoms affect life, or do not want to take long-term medication;
Perennial attacks, once the drug is stopped, the author will be issued immediately;
Those who have side effects of the drug, or who are worried about the side effects of long-term use;
Women of childbearing age, who are afraid of seizures during pregnancy and breastfeeding and cannot take the drug;
The nasal cavity has obvious anatomy Variation, accompanied by dysfunction, such as nasal septum deviation, nasal polyps, sinusitis and so on.
Which patients should not be surgically treated for allergic rhinitis?
High blood pressure, severe cardiopulmonary insufficiency;
Bleeding tendency;
Pregnant or menstruating women.
Surgical treatment of allergic rhinitis provides a new opportunity for patients who have failed conservative treatment to reduce the impact of allergic rhinitis on their lives and improve their quality of life.