Abstract
Japanese cedar (JC) pollinosis is the most common form of allergic rhinitis (AR) in Japan, and its prevalence is only increasing. Now, more than one-third of Japanese people are estimated to suffer from JC pollinosis. Recently, sublingual immunotherapy (SLIT) with a standardized JC pollen and house dust mite (HDM) extract has been adopted in Japan for treatment of the respective forms of AR. At our department, SLIT with JC pollen and HDM significantly improved the nasal symptoms in patients with JC pollinosis and HDM-induced AR, respectively. The improvement became manifest from the first year of SLIT and remained sustained thereafter. SLIT with JC pollen decreased the Athens Insomnia Scale scores during the pollen season in patients with JC pollinosis. These findings suggest that SLIT with JC pollen suppresses nasal symptoms, leading also to improvement in AR-related sleep disturbance. Posterior nasal neurectomy (PNN) is effective for suppressing nasal discharge and sneezing in patients with refractory AR. Our questionnaire survey showed that improvement of the nasal symptoms, remained sustained for at least 5 years in patients with refractory AR who underwent PNN at our department. Our findings suggest that the long-term prognosis after PNN is satisfactory in patients with refractory AR.
