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Effect of Endoscopic Posterior Nasal Neurectomy on Laryngectomy-associated Rhinorrhea: A Feasibility Study.
Lin, Yu-Hsuan; Huang, Ching-Yuan.
Afiliação
  • Lin YH; Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.; lucaslinyh@gmail.com.
  • Huang CY; Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan, R.O.C.
In Vivo ; 37(6): 2648-2653, 2023.
Article em En | MEDLINE | ID: mdl-37905635
BACKGROUND/AIM: Refractory rhinorrhea is common after total laryngectomy (TL). Because botulinum toxin injection and ipratropium bromide nasal spray have shown success in it, suggesting a hyperactive parasympathetic tone may play a role. Therefore, we sought to evaluate whether endoscopic posterior nasal neurectomy (ePNN) to include more nasal secretomotor fibers is a treatment option for laryngectomy-associated rhinorrhea. PATIENTS AND METHODS: Laryngectomized patients with persistent rhinorrhea who underwent ePNN at both the middle and inferior meatus were enrolled. We evaluated the changes in 2-week Total Nasal Symptoms Score (TNSS) and rhinorrhea subscore over 6 and 12 months post ePNN treatment, as well as self-rated rhinorrhea using the visual analogue scale (VAS) at pretreatment and 12 months post-treatment. Adverse events, post-procedure medication reliance, and patient satisfaction were recorded. RESULTS: Five males (mean age, 62.4 years) with elapsed time from TL of 97.56±89.91 months were identified. ePNN significantly improved the average rhinorrhea subscore of TNSS at six months (p=0.037, Wilcoxon sign-rank test) and twelve months (p=0.047) compared to baseline. There were marginally significant improvements between baseline and at 12 months for overall TNSS (6.60±2.30 to 2.00±1.22, p=0.056) and VAS for rhinorrhea (7.80±0.84 to 2.00±1.58, p=0.062). No adverse event was reported, and four patients had excellent outcomes. CONCLUSION: Endoscopic posterior nasal neurectomy is a safe and efficient alternative treatment for laryngectomy-associated rhinorrhea, with lasting improvement over one year. However, a large-scale study with more comprehensive measurements is needed to verify its long-term efficacy.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Ipratrópio / Laringectomia Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Ipratrópio / Laringectomia Idioma: En Ano de publicação: 2023 Tipo de documento: Article