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Cryothérapie nasale postérieure dans la rhinite chronique réfractaire : déterminants anatomiques et résultats cliniques
Mémoire de Master / Thèse d'exercice   Open Access

Cryothérapie nasale postérieure dans la rhinite chronique réfractaire : déterminants anatomiques et résultats cliniques

Juliette Sliman
Masters , Université de Montpellier
13/10/2023

Résumé

Chronic rhinitis Nonallergic rhinitis Nasal hyperreactivity Tomodensitometry Posterior nasal nerve Vidian nerve Rhinite chronique Rhinite non-allergique Hyperréactivité nasale Scanner Nerf nasal postérieur Nerf vidien Rhinitis, Allergic Rhinitis, vasomotor Rhinorrhea Cryotherapy Cryosurgery Rhinite allergique Rhinite vasomotrice Rhinorrhée Cryothérapie
With an estimated prevalence of 30% of the general population, chronic rhinitis is a very common disease, classically separated into two groups: allergic and non-allergic rhinitis. The impact of this pathology on the quality of life of patients remains major despite appropriate treatment according to the etiology, and up to 20% of patients remain insufficiently relieved.Among the new treatments proposed, cryotherapy of the posterior nasal nerve (PNN) aims to act directly on the parasympathetic control of the nasal mucosa. Its effectiveness seems to depend on one hand on the anatomical variations specific to each patient and the technique of cryostat’s application; and on the other hand, on the indication according to predominant symptoms.The present work aims 1) to study the anatomical variations of interest for the endoscopic application of cryotherapy on the posterior nasal nerves, and 2) to present the “real life” results of the PNN cryotherapy in a French population, through two articles:- “Anatomical variations of interest for posterior nasal nerve cryotherapy in the treatment of chronic rhinitis: a population study”.- “Posterior nasal nerve cryotherapy for chronic refractory rhinorrhea and nasal hyperreactivity: a French retrospective study”.PNN cryotherapy appears effective in most cases for the treatment of chronic refractory rhinitis, regardless of the etiology. A standardized application technique, with defined anatomical landmarks should allow to integrate it into the therapeutic arsenal for chronic refractory rhinorrhea and NHR.

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