{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:41:03Z","timestamp":1791301263854,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T00:00:00Z","timestamp":1668038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rhinitis affects up to 40% of the population worldwide and can significantly reduce quality of life. Some patients remain symptomatic despite maximal medical therapy. In refractory cases, posterior nasal neurectomy (PNN\u2014the endoscopic division of the intranasal nerve branches containing postganglionic parasympathetic fibres) is postulated to reduce symptom burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives of Review<\/jats:title>\n                    <jats:p>To establish whether PNN is effective and safe in the management of allergic and non\u2010allergic rhinitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Type of Review<\/jats:title>\n                    <jats:p>Systematic review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature search was undertaken using PubMed, EMBASE, MEDLINE, and Cochrane. The inclusion criteria were: studies published in English, studies where PNN was performed either with or without additional procedures, and where measures of objective\/subjective outcomes and\/or complications were reported. Extracted data included study type, sample size, surgical technique, study population characteristics, follow\u2010up period, outcome measures, complications of surgery, and symptom outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 23 articles satisfied the inclusion criteria studying in total 2282 patients. Sample size ranged from 8 to 1056. There were 3 randomised controlled trials, 3 case\u2010control studies, and the remaining 17 were case series using both objective and subjective outcome measures. All but one study found improved patient\u2010reported outcomes following PNN. Complications were reported in 14 studies\u2014epistaxis was the most common complication and was observed in 30 patients (1.5% of subjects).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PNN had a low rate of complications. Although most studies reported significant symptomatic improvement, their heterogeneity, level of evidence, study design, and\/or quality was not sufficient to draw any firm conclusions on the effectiveness of the procedure. Larger, well\u2010designed studies are needed to clarify its role in the management of difficult\u2010to\u2010treat rhinitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.13991","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T12:15:04Z","timestamp":1666008904000},"page":"95-107","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Posterior nasal neurectomy for intractable rhinitis: A systematic review of the literature"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3451-9957","authenticated-orcid":false,"given":"Mun Leng","family":"Lee","sequence":"first","affiliation":[{"name":"Ear, Nose and Throat (ENT) Department NHS Greater Glasgow and Clyde, Queen Elizabeth University Hospital  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3112-0393","authenticated-orcid":false,"given":"Patrick Daragh","family":"Chakravarty","sequence":"additional","affiliation":[{"name":"Ear, Nose and Throat (ENT) Department NHS Greater Glasgow and Clyde, Queen Elizabeth University Hospital  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0233-3709","authenticated-orcid":false,"given":"David","family":"Ellul","sequence":"additional","affiliation":[{"name":"Ear, Nose and Throat (ENT) Department NHS Greater Glasgow and Clyde, Queen Elizabeth University Hospital  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,10]]},"reference":[{"issue":"3","key":"e_1_2_11_2_1","first-page":"258","article-title":"Towards a new epidemiological definition of chronic rhinitis: prevalence of nasal complaints in the general population","volume":"59","author":"Klementina S","year":"2021","journal-title":"Rhinology"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2008.06.003"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13601-015-0083-6"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/194589240602000216"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-010-1482-x"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1994.01880360045009"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI114780"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000338945.54863.D9"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/1907862"},{"key":"e_1_2_11_11_1","first-page":"24","article-title":"Endoscopic posterior nasal neurectomy: an alternative to Vidian neurectomy","volume":"9","author":"Kanaya T","year":"2009","journal-title":"Oper Tech Otolaryngol"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2007.01.008"},{"issue":"7","key":"e_1_2_11_13_1","first-page":"4864","article-title":"Treating moderate\u2010to\u2010severe persistent allergic rhinitis by endoscopic posterior nasal neurectomy: a study of efficacy and effects on autophagy","volume":"13","author":"Zhang Y","year":"2020","journal-title":"Int J Clin Exp Med"},{"issue":"21","key":"e_1_2_11_14_1","first-page":"00091\u20104","article-title":"The long\u2010term outcomes of posterior nasal neurectomy with or without pharyngeal neurectomy in patients with allergic rhinitis: a randomized controlled trial","volume":"1808","author":"Hua H","year":"2021","journal-title":"Braz J Otorhinolaryngol"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2013.10.018"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016480500472853"},{"issue":"1","key":"e_1_2_11_17_1","first-page":"113","article-title":"Endoscopic posterior nasal neurectomy with continuou suction irrigation method","volume":"1","author":"Kanaya T","year":"2017","journal-title":"J Otolaryngol Res"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1515\/rjr-2017-0009"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.32412\/pjohns.v33i1.15"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s42399-019-00091-4"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002221511900166X"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102410"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2020.12.009"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2015.12.001"},{"key":"e_1_2_11_25_1","unstructured":"NIH National Heart Lung and Blood Institute Quality Assessment Tool.Study Quality Assessment Tools. 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