Abstract
The purpose of this report is to describe a novel technique for endoscopic vidian neurectomy (EVN) based on preoperative computed tomography (CT) classification of the vidian canal (VC), and to present anatomical and surgical findings from an initial series. Retrospective study, consisting of medical chart review and patient interviews, of all preoperative CT-guided EVN procedures was performed from 2006 to 2010 at a tertiary-care medical center. A total of 89 patients with intractable rhinorrhea (77 males and 12 females, mean age 29 years, age range 16–57 years) underwent bilateral EVN. Configuration of the VC was classified into three types based on preoperative CT findings. The technique for surgical access of each of these configurations is presented. The most common configuration of the VC was type 2 (47%). A wide, direct, and safe exposure of the vidian nerve was achieved in all cases. 84 of 89 patients completed the questionnaires regarding the postoperative improvement in quality of life. Follow-up ranged from 2 to 42 months, with an average of 19.6 months. 77 of 84 (91.7%) patients were satisfied with their surgical result. Two patients underwent revision ETSVN due to relapsed symptoms. With the help of a preoperative CT scan of the paranasal sinuses, the vidian nerve can be identified precisely via an endoscopic intrasphenoidal or transsphenoidal approach, which provides an easy and reliable way to perform vidian neurectomy.
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References
Bagatella F (1986) Vidian nerve surgery revisited. Laryngoscope 96:194–197
Chandra R (1969) Transpalatal approach for vidian neurectomy. Arch Otolaryngol 89:542–545
El Shazly M (1991) Endoscopic surgery of the vidian nerve: preliminary report. Ann Otol Rhinol Laryngol 100:536–539
Golding-Wood PH (1961) Observations on petrosal and vidian neurectomy in chronic vasomotor rhinitis. J Laryng 75:232–247
Kim HS, Kim DI, Chung IH (1996) High-resolution CT of the pterygopalatine fossa and its communications. Neuroradiology 38:S120–S126
Kamel R, Zaher S (1991) Endoscopic transnasal vidian neurectomy. Laryngoscope 101:316–319
Lee JC, Hsu CH, Kao CH, Lin YS (2009) Endoscopic intrasphenoidal vidian neurectomy: how we do it. Clin Otolaryngol 34:568–571
Lee JC, Hsu CH, Kao CH (2010) Endoscopic vidian neurectomy. An online video tutorial: how to do it. Clin Otolaryngol 35:496–499
Minnis NL, Morrison AW (1971) Transseptal approach for vidian neurectomy. J Laryngol Otol 85:255–260
Robinson SR, Wormald PJ (2006) Endoscopic vidian neurectomy. Am J Rhinol 20:197–202
Yazar F, Cankal F, Haholu A et al (2007) CT evaluation of the vidian canal localization. Clin Anat 20:751–754
Acknowledgments
This work was supported in part by a grant from the Research Fund of Tri-Service General Hospital (TSGH-C100-100), Taipei, Taiwan.
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Lee, JC., Kao, CH., Hsu, CH. et al. Endoscopic transsphenoidal vidian neurectomy. Eur Arch Otorhinolaryngol 268, 851–856 (2011). https://doi.org/10.1007/s00405-010-1482-x
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DOI: https://doi.org/10.1007/s00405-010-1482-x