Endoscopic Transseptal Vidian Neurectomy

Objective: Evaluation of the endoscopic transseptal approach of vidian neurectomy. Design: A case series, with a follow-up of 12 to 24 months. Setting: A referral center. Patients: A consecutive sample of 11 adult patients with resistant vasomotor rhinitis: eight with severe rhinorrhea and three with recurrent nasal polyposis. All patients had a negative history of allergy and negative skin tests. All patients completed the study. Intervention: The rigid nasal endoscope was used through a transseptal approach to reach the sphenopalatine foramen and to cut the vidian nerve. Main Outcome Measures: Intraoperative identification and cutting of the vidian nerve under direct endoscopic vision. Postoperative evaluation of rhinorrhea, sneezing, and recurrent disease. Results: The vidian nerve was identified and sectioned bilaterally in all cases. Immediate and complete cessation of rhinorrhea uniformly occurred. Paroxysms of sneezing were vastly reduced. No recurrence was detected, except in one case. Three patients complained of dry eyes, but they had symptomatic relief with artificial teardrops. Conclusion: The technique of endoscopic transseptal vidian neurectomy is a minor surgical procedure with high efficacy and minimal postoperative morbidity. More cases and longer follow-up are necessary to provide long-term results. © 1994, American Medical Association. All rights reserved.