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Although the best management of allergic rhinitis is medical, intractable cases are not uncommon. Immunotherapy helps but is more practical if there is a single allergen involved. The authors compare the effects of submucosal inferior turbinoplasty alone with submucosal turbinoplasty plus resection of branches of the posterior nasal nerve in the inferior turbinate. There were about 20 matched patients in the two groups. Based on patient questionnaires, it was noted that postoperative sneezing and nose blowing decreased more in the group who also had branches of the posterior nasal nerve resected whereas nasal obstruction decreased equally in the two groups. Olfaction was studied subjectively and with an olfactometer in terms of olfaction detection and recognition thresholds pre- and post-operatively. Olfaction improved significantly more in the group who also had branches of the posterior nasal nerve resected. The explanation offered is that after nerve resection, reduced rhinorrhoea helps restore olfaction. In comparison with a previous study involving resection of the posterior nasal nerve near the sphenopalatine foramen, this procedure is considered equally effective and much safer. Symptoms of rhinitis can be difficult to treat, and this method appears applicable.

The effects of resection of the peripheral branches of the posterior nasal nerves in the inferior turbinate with special focus on olfactory dysfunction.
Suzuki M, Yokota M, Ozaki S, Murakami S.
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Madhup K Chaurasia

United Lincolnshire Hospitals NHS Trust; University of Leicester, UK.

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