Sphenopalatine artery ligation with nerve resection in patients with vasomotor rhinitis and polyposis: a prospective, randomized, double-blind investigation.

Conclusions Sphenopalatine artery ligation relieves symptoms of rhinorrhea, sneezing and nasal itching in patients with vasomotor rhinitis associated with nasal polyps. Objectives. Nasal polyps often arise in a setting of vasomotor rhinitis. Responsible for the accompanying symptoms of rhinorrhea, sneezing and nasal itching are dysfunctions in nerve fiber activity of the sympathetic and parasympathetic systems. Sphenopalatine pedicle resection with autonomic denervation could potentially reduce related symptoms. Methods In a prospective, double-blind setting, 60 patients with vasomotor rhinitis and bilateral nasal polyps randomly assigned to functional endoscopic surgery either with (Group A) or without sphenopalatine artery ligation (Group B) completed a 3-year follow-up. Pre-operative and post-operative (at 1 and 3 years) evaluations included symptom score, fiberendoscopy, and active anterior rhinomanometry. Results. In both treatment groups nasal breathing had improved at 1-year and 3-year follow-up (P<0.001), whereas a improvement in rhinorrhea (P<0.001), sneezing and itching (P<0.01) was attained only in group A. The inter-group comparison showed that a statistically significant improvement in rhinorrhea and nasal itching (P=0.002) and in sneezing (P< 0.001) was present in Group A at both follow-up controls. Rhinomanometry improved in both treatment groups (P<0.01). Inter-group comparison showed a significant difference only at the 3-year follow-up visit (P<0.05).