Long-term results of selective vidian neurectomy for allergic rhinitis.

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Vidian neurectomy is the most effective treatment of allergic rhinitis with dominant symptoms of paroxysmal sneezing and rhinorrea. Although these symptoms disappear dramatically after this operation, most patients usually suffer from prolonged xerophthalmia. Therefore, we devised a method which reduces allergic symptoms and does not cause dry eyes on the basis of studies reported by Takahashi (1973) and Nomura(1971).Using this procedure we operated on 55 patients who had allergic rhinitis with persistent symptoms in spite of conservative therapies including desensitization. The ages of the patients were between 15 and 47. The average period of post-operative observation was 2 years and 4 months.The maxillary antrum is opened as in the Caldwell-Luc method and the posterier wall removed. The periosteum of the pterygopalatine fossa is then peeled off andpressed laterally. The vidian canal is reached subperiosteally above the sphenomaxillary sur face of the sphenoid. In front of the canal, post-ganglionic fibers (post-nasalbranch) enter medially through the sphenopalatine foramen with the sphenopalatine artery. This branch is sectioned after electrocauterization subperiosteally. About 90percent patients were relieved of symptoms with no decrease of lacrimation. There were no serious complications.
耳鼻咽喉科臨床学会の論文