engleski

Cauterization of the posterior nasal nerves (sphenopalatine nerve) in the treatment of nasal polyposis.

Introduction : From January 1996 to January 2001 145 patient were treated with combined medicamentous therapy and endoscopic surgery. Endonasal endoscopic sphenoethoimidectomy with resection of the posterior one third of middle nasal turbinate was performed. Because of intensive bleeding from posterior nasal artery we had to cauterize it to stop bleeding and noticed fewer incidences in polyp recurrence. For that reason from January 1997 we started with obligatory cauterization of posterior nasal nerves. We present our data and experience with this technique. Material : from 107 patients with regular follow-up two paired groups regarding gender and Lund-Mckay CT staging score were established. Both groups (with and without cauterization) had 35 patients with Loand-Mckay CT staging score 15543 among whom 20 were male and 15 female patients. Analyzed were all anamnestic, local endoscopic and CT data and statistically correlated. Presults : In the first group endoscopic recurrence was 68.6% and in the second group 10% (p-O.O 18). Medium breathing score on the analogue visual scale for the first group was 7743 and for the second group 8114. Conclusion : Cauterization of posterior nasal nerves statistically significant reduces the endoscopic recurrence of nasal polyposis. Possible mechanism is regrowth and remodeling of the nerves with subscquent normalization of neuroimmunomodulation. We recommend the cauterization as an obligatorv procedure and suggest further clinical and experimental trials regarding impaircd neuroimmunomodulation as the cause of nasal polyposis.

Posterior nasal nerve ; nasal polyposis ; treatment

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