Comprehensive FESS with and without Vidian neurectomy for management of chronic rhinosinusitis with nasal polyposis (CRSwNP)

Background: Managing Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP) is always challenging. Because of the chronicity of the disease and its intractable course, most patients present with a recurrence of the disease. Vidian neurectomy/ Posterior nasal neurectomy (PNN) can be effective in alleviating symptoms of CRSwNP.Materials and Methods: The study was conducted at ENT department of Zagazig university and Elgalaa military hospital from January 2022 to January 2023. A total of 26pts with CRSwNP had been included in this work (12 pts in the control group, 14pts in the study group). The patients in the study group underwent FESS with Vidian neurectomy /or selective posterior nasal neurectomy and the pts in the control group underwent FESS only. The symptoms and quality-of-life improvement were assessed at 1, 3 and 6 months after the surgery.Results: On intragroup analysis between the preoperative and postoperative scores, sinonasal outcome test (SNOT-22), we found a significant difference for each (p<0.05). When the improvement of outcome scores was compared between the two groups, a significant difference was obtained for SNOT-22 scores at 6 months (p<0.05).Conclusion: The impact of Vidian neurectomy and PNN on Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) lacks sufficient study in current literature. While these procedures showed initial improvement in clinical symptoms and quality of life up to 24 weeks post-surgery, the lasting benefit was limited in CRSwNP patients. Larger studies with extended follow-up are needed to fully grasp the effectiveness of PNN in CRSwNP patients.