Complication rates
Bleeding was the most common complication of the procedure and affected
1.6% of patients. In the studies reporting higher rates, all patients
underwent turbinate reduction in addition to PNN. Sensory disturbance of
the palate or lip was also observed as a complication, but this was
noted to be usually transient. Ogi(25) was the only study that reported
permanent numbness. Interestingly the authors reported similar rates of
persistent numbness in the control group that underwent ESS without PNN.
Their surgical procedure involved turbinate reduction using an incision
anterior to the anterior pole of the inferior turbinate (at the level of
the pyriform aperture) where terminal branches of the infraorbital nerve
might be found on the anterior surface of the maxillary bone. Indeed
Sonoda(28) also noted that it is likely to be the turbinate reduction or
septoplasty component of the surgery that was likely responsible for
dental or palatal numbness. Only 1 patient across all the studies
reported persistent mild dryness of the eyes following the procedure but
this did not require any treatment(28).