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.