INTRODUCTION
Rhinitis is an inflammatory condition of the nasal mucosa resulting in
nasal obstruction, rhinorrhoea, sneezing and post-nasal drip. It is a
global health problem and affects up to 40% of the population
worldwide(1). It can have a significant impact on quality of life
(QoL)(2, 3).
Management of rhinitis varies depending on the endotype and generally
includes allergen or irritant avoidance, intranasal corticosteroid
sprays, nasal saline rinses, oral or topical histamine-2 antagonists,
ipratropium nasal sprays, leukotriene receptor antagonists, and
immunotherapy. Turbinate surgery, vidian neurectomy, and more recently
endoscopic posterior nasal neurectomy (PNN), are generally reserved for
patients with disabling symptoms refractory to medical treatment.
Vidian neurectomy has been shown to effectively relieve the symptoms of
both allergic and non-allergic rhinitis by dividing the preganglionic
parasympathetic supply to the nasal mucosa(4,5). However, it can result
in xerophthalmia as the preganglionic fibres to the lacrimal gland are
also inevitably divided during the procedure. Other complications
include palatal and cheek numbness, ophthalmoplegia, and visual
loss(4-6). PNN is a relatively recent surgical technique which avoids
many of these complications, particularly xerophthalmia and maxillary
nerve injury.