Robinson Simon R, Wormald Peter John
Department of Surgery-Otolaryngology Head and Neck Surgery, Adelaide and Flinders Universities, South Australia, Australia.
Am J Rhinol. 2006 Mar-Apr;20(2):197-202.
Vidian neurectomy has in the past been advocated for the treatment of vasomotor rhinitis. With the recent better understanding of nasal and sinus anatomy, the surgical technique and outcomes of this procedure have been reassessed in this preliminary report.
A total of nine patients with symptoms of vasomotor rhinitis underwent 14 endoscopic vidian neurectomies between 1998 and 2001. All patients had negative screening for allergies on their serum or on skin-prick tests. The surgical technique for endoscopic vidian neurectomy is presented. The outcomes for the patients were retrospectively assessed with patients asked to score their pre- and postoperative symptoms rating these symptoms on a scale of 1-10 after a mean follow-up of 25 months (range, 21-36 months).
On this retrospective analysis there was a significant improvement in the symptoms of rhinorrhea (p = 0.018) and nasal obstruction (p = 0.011). There was no significant difference between the pre- to postoperative symptoms for postnasal drip or sneezing. The most common minor adverse effect was dry eyes (35.7%) and nasal crusting (28.6%).
Endoscopic vidian neurectomy improves the symptoms of nasal obstruction and rhinorrhea in patients with vasomotor rhinitis.
过去曾提倡经岩大神经切断术治疗血管运动性鼻炎。随着近期对鼻腔和鼻窦解剖结构有了更好的认识,本初步报告对该手术的技术和疗效进行了重新评估。
1998年至2001年间,共有9例血管运动性鼻炎患者接受了14次内镜下岩大神经切断术。所有患者血清或皮肤点刺试验的过敏筛查均为阴性。介绍了内镜下岩大神经切断术的手术技术。对患者的疗效进行回顾性评估,要求患者在平均随访25个月(范围21 - 36个月)后,对术前和术后症状进行评分,症状评分为1 - 10分。
在这项回顾性分析中,鼻漏症状(p = 0.018)和鼻塞症状(p = 0.011)有显著改善。鼻后滴漏或打喷嚏的术前和术后症状之间无显著差异。最常见的轻微不良反应是干眼(35.7%)和鼻痂形成(28.6%)。
内镜下岩大神经切断术可改善血管运动性鼻炎患者的鼻塞和鼻漏症状。