Long-term nasal congestion and sneezing cannot be cured. Doctor: Posterior nasal nerve cautery can help improve allergic rhinitis

Cai Jiansheng, an otolaryngologist at Kuok General Hospital, said that according to research from the American Medical Association and my country, posterior nasal nerve cautery has significant short-term effects on allergic and non-allergic rhinitis.

Mr. Wang, 25 years old, had allergic rhinitis in childhood and suffered from long-term nasal congestion, sneezing, runny nose and other symptoms. He had tried oral medicine and spray to treat it without success. The otolaryngologist's examination revealed that the nasal septum was curved, the inferior turbinate was thickened, and nasal mucus accumulated. He underwent nasal septum plasticity surgery, radiofrequency-assisted inferior turbinate plastic surgery, and posterior nasal nerve laser cauterization surgery at his own expense. He recovered well after the operation, and the nasal passages were clear. Allergy symptoms were also well controlled.

Cai Jiansheng, an otolaryngologist at Kuo General Hospital, said that the prevalence rate of allergic rhinitis in Taiwan is about 20% to 30%, and the proportion is higher in urban areas with severe air pollution. If parents have this symptom, their children are also prone to allergies. In addition to genetics, air pollution, weather changes and second-hand smoke are all allergen risk factors. Such patients should often wear masks, use indoor air purifiers, wash pillows and quilt covers frequently, and avoid contact with stuffed toys. Preventing allergens is the primary method.

Cai Jiansheng pointed out that the principle of allergic rhinitis is that exposure of the nasal mucosa to foreign substances triggers an overreaction of the immune system, resulting in a series of symptoms including sneezing, runny nose and other symptoms. In terms of treatment, allergen avoidance and drug treatment will be the first priority, including antihistamine and steroid nasal sprays to reduce the inflammation and swelling of the nasal mucosa. If the symptoms are not relieved, it is the time for surgical intervention.

Traditional nasal allergy surgery can be divided into inferior turbinate debulking surgery and vidian nerve resection surgery covered by health insurance. The former reduces the volume of the inferior turbinate, increases the space in the nasal passages and reduces nasal congestion, and is effective in controlling nasal congestion, but has limited control over allergic symptoms; the latter cuts the vidian nerve and reduces the influence of parasympathetic nerves on nasal secretion, but is highly destructive and may cause the risk of dry eye syndrome.

Cai Jiansheng said that the posterior nasal nerve cautery, which requires self-pay, is a new surgery developed in recent years. It cauterizes the posterior nasal nerve of the vidian nerve, thereby reducing the destructiveness of traditional surgery and the risk of dry eye complications, and effectively controlling allergic symptoms.

The 2022 American Rhinological Society stated that this surgery has a significant therapeutic effect on allergic and non-allergic rhinitis, but it should still be noted that this surgery is a "cauterization block" rather than a complete "resection" of the nerves. There is a chance of medium and long-term recurrence, and follow-up is required after the surgery if necessary.