Endoscopic Vidian Neurectomy

Robinson, Simon; Wormald, Peter John

doi:10.1177/194589240602000216

Cited by 89 publications

(137 citation statements)

References 16 publications

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“…The endoscopic vidian neurectomy spares the patient a facial incision, diminishes the need for dissection within the midface, and lessens the potential morbidities secondary to traditional approaches. Several endoscopic transnasal techniques for vidian neurectomy have been proposed [3,6,10]. Our new technique has several advantages compared with the previously described endoscopic transnasal approaches.…”

Section: Discussionmentioning

confidence: 96%

“…Authors have hypothesized recently that the unfavorable results of vidian neurectomy reported in previous studies might be due to the fact that the vidian nerve was never visualized accurately in its canal while sectioned under direct vision [10]. The evolved practice of vidian neurectomy under direct vision seems to be a key in determining surgical result.…”

Section: Discussionmentioning

confidence: 97%

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Endoscopic transsphenoidal vidian neurectomy

Lee

Kao

Hsu

et al. 2011

Eur Arch Otorhinolaryngol

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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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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Endoscopic transsphenoidal vidian neurectomy

Lee

Kao

Hsu

et al. 2011

Eur Arch Otorhinolaryngol

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“…Robinson and Wormald were the first ones who took advantage of sphenoid sinus as guidance. (Robinson and Wormald 2006) He claimed that enlargement of the sphenopalatine foramen posteriorly up to the anterior face of the sphenoid to the level of the floor of the sphenoid sinus using a bone punch facilitated the identification of vidian nerve in the PPF. To eliminate the intimidation of vascular risk, the SPA should be cauterized first.…”

Section: History Of Vidian Neurectomymentioning

confidence: 99%

Endoscopic Vidian Neurectomy: The Anatomy Consideration and Preoperative Images Analysis

Su¹,

Liu²,

Wang³

2012

Computed Tomography - Clinical Applications

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IntroductionAlthough surgery is not a primary treatment for manaing rhinitis, it can have some adjuvant benefit in patients with significant nasal congestion or poor pharmacologic response. It is usually performed by surgical approaches to the inferior turbinate, and the more aggressive procedures such as the vidian neurectomy have not been widely applied. Traditional approaches to the vidian canal necessitate larger incisions, including transseptal, transpalatal and transantral methods. These approaches are often not reliable and at the risk of injury to the abutting neurovascular structures. Pioneers in endoscopic surgery are exploring alternatives to these traditional techniques in an attempt to minimize morbidity and the lack of irrelevant incisions. The main difficulties encountered during endoscopic approach are anatomic variations such as canal wall dehiscence, intra-sphenoid septa, pneumatization degree of pterygoid process and the relationship between vidian canal and middle turbinate. Those variations will have effect in determining the surgical success rate and the related complications. Therefore, a powerful tool, in the purpose of identifying the canal location and its surrounding anatomy, is very important to guide the surgeon in preoperative assessment and intraoperative approach. Computed tomography (CT) scanning is superior for the evaluation of the bony confines of the sinonasal tract and skull base. The most minimal recesses of the sinonasal region are easily assessed and it is possible to evaluate the position and configuration of the vidian canal. That valuable information provided by imaging studies enhances the surgical feasibility and offers an alternative for treating the rhinitis. This chapter describes the use of CT images in this capacity. Growing surgical experience and evolving technology will help to advance the feasibility of endoscopic vidian neurectomy and elucidate their indications by using preoperative images.

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“…Vidian neurectomy can be performed using different methods. Robinson and Wormald (25) described endoscopic transnasal Vidian neurectomy in 2006, and Liu et al (22) described endoscopic transsphenoidal Vidian neurectomy.…”

Section: Discussionmentioning

confidence: 99%

Vidian Canal Types and Dehiscence of the Bony Roof of the Canal: An Anatomical Study

Yeğin¹,

Çelik²,

Altıntaş³

et al. 2017

Turk Arch Otorhinolaryngol

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Objective: To determine the prevalence of Vidian canal types and dehiscence of the bony roof of the canal. Methods:This study included 594 patients (391 males and 203 females; average age, 32.43±11.98 years; range, 18-65 years). Computed tomography (CT) images were analyzed in terms of the prevalence of Vidian canal types and dehiscence of the bony roof of the canal.Results: Vidian canal types 1, 2, and 3 based on the sphenoid sinus body were found on the right side in 33.8%, 29.7%, and 6.5%, and on the left side in 36.4%, 27.4%, and 36.2% of the patients, respectively. Dehiscence of the bony roof of the canal was found on the right side in 22.2% of the patients and on the left side in 26.6%. In terms of Vidian canal types based on the sphenoid sinus floor, types 1, 2, 3, and 4 were found on the right side in 53.5%, 27.4%, 7.6%, and 11.5%, and on the left side in 54.9%, 26.6%, 6.6%, and 11.9% of the patients, respectively. On the right side, Vidian canal type 2 was significantly (p=0.002) more frequent in males than in females. Conclusion:When studying the complex anatomy of the sphenoid sinus, it is essential to consider Vidian canal types. Before endoscopic sinus surgery the Vidian canal and other anatomical structures should be carefully evaluated in all patients during preoperative paranasal sinus CT imaging to avoid complications.

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Endoscopic Vidian Neurectomy

Abstract: Endoscopic vidian neurectomy improves the symptoms of nasal obstruction and rhinorrhea in patients with vasomotor rhinitis.

Cited by 89 publications

References 16 publications

Endoscopic transsphenoidal vidian neurectomy

Endoscopic transsphenoidal vidian neurectomy

Endoscopic Vidian Neurectomy: The Anatomy Consideration and Preoperative Images Analysis

Vidian Canal Types and Dehiscence of the Bony Roof of the Canal: An Anatomical Study

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