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. 2010 Dec;3(4):212-6.
doi: 10.3342/ceo.2010.3.4.212. Epub 2010 Dec 22.

Long-term effectiveness and safety of endoscopic vidian neurectomy for the treatment of intractable rhinitis

Tae Young Jang  1 , Young Hyo Kim, Seung-Ho Shin
Affiliations

Long-term effectiveness and safety of endoscopic vidian neurectomy for the treatment of intractable rhinitis

Tae Young Jang et al. Clin Exp Otorhinolaryngol. 2010 Dec.

Abstract

Objectives: Vidian neurectomy could be considered the treatment of choice for intractable rhinitis, because it is the only method that can permanently block the pathophysiological mechanism of rhinitis. The goal of this study was to evaluate the effect of vidian neurectomy on nasal symptoms and tear production, and to assess for possible complications.

Methods: Six patients with intractable rhinitis who underwent endoscopic transnasal vidian neurectomy were enrolled. The degree of symptom improvement and complications were assessed through retrospective review of medical records prior to, and 1 year following surgery, and telephone survey after 6.9±2.1 years. Schirmer's test was performed before surgery, and these values were compared to postoperative results at 1 day, 1 month, and 2 months.

Results: Changes in the visual analogue scale were significant in nasal obstruction (8.5±2.5 to 3.0±2.0, P<0.05) and rhinorrhea (9.0±2.2 to 2.0±1.6, P<0.05). Improvements persisted for up to 7 years after the primary surgery. Patients complained of mild dry eyes for 1 month after vidian neurectomy. However, five out of six reported marked improvement of xerophthalmia after 2 months. Aside from mild crusting of the nasal cavity and mild postoperative pain, there were no major complications. During the entire follow-up period, no patient needed additional treatment, such as antihistamines or corticosteroids.

Conclusion: Vidian neurectomy is effective in alleviating nasal symptoms in patients with intractable rhinitis refractory to other treatments. This effect is sustained for at least 7 years with minimal postoperative complications.

Keywords: Allergic rhinitis; Endoscopy; Schirmer's test; Vidian nerve.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
The mean visual analogue scale (VAS) of nasal symptoms pre-surgery, 1 year, and 7 years after vidian neurectomy. 1, nasal obstruction; 2, rhinorrhea; 3, sneezing; and 4, itching. (Wilcoxon signed rank test, *P<0.05, **P<0.01). TNSS: total nasal symptom score.
Fig. 2
Fig. 2
The results of the Schirmer's test before and after surgery (immediate postoperative period, 1 month, and 2 months after the operation) (Wilcoxon signed rank test, *P<0.05).
Fig. 3
Fig. 3
Change in medication score after vidian neurectomy (Wilcoxon signed rank test, **P<0.01).
See this image and copyright information in PMC

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