Study on the Efficacy of Vidian Neurectomy in Combined Ocular‐Nasal Therapy for Allergic Rhinoconjunctivitis

OBJECTIVE: To evaluate the efficacy of vidian neurectomy (VN) in improving nasal and ocular symptoms in patients with drug-refractory allergic rhinoconjunctivitis (ARC). STUDY DESIGN: A prospective randomized controlled study. SETTING: Yiyang Central Hospital. METHODS: A total of 220 patients with drug-refractory ARC were allocated to the VN (n = 110) and fluticasone propionate (FP) (n = 110) groups. Clinical data, serum, and tear samples were collected at baseline and at 1 week, 2 weeks, 1 month, and 3 months after treatment. Serum immunoglobulin E (IgE), IgG, and IgA levels, tear meniscus height (TMH), tear break-up time (TBUT), tear secretion (via Schirmer's test [SIT]), and eosinophil cationic protein (ECP) and histamine (HA) were assessed. A 1-year follow-up was conducted to evaluate complications and recurrence, and the Kaplan-Meier curves were plotted to show the recurrence rates. RESULTS: Following treatment, patients in the VN group showed reduced serum IgE, IgG, IgA, ECP, and HA levels, and Visual Analog Scale (VAS), Sino-Nasal Outcome Test-20, Total Nasal Symptom Score, corneal fluorescein staining, and Rhinoconjunctivitis Quality of Life Questionnaire scores, and increased TMH, TBUT, and SIT. Both groups demonstrated symptom relief (reduced VAS scores); however, the VN group achieved greater and more sustained improvement, particularly at 3 months, whereas the FP group plateaued after 1 month. Although complications were more frequent in the VN group, the 1-year recurrence rate was lower. CONCLUSION: VN significantly improves nasal and ocular symptoms, reduces immunologic and inflammatory markers, and lowers short-term recurrence in drug-refractory ARC, indicating favorable clinical potential.