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Eighteen years of personal experience of Vidian neurectomy by the author's trans‐antral route in 242 patients is fully reviewed with longterm follow‐up. In otherwise intractable and severe cholinergic (non‐atopic) chronic vasomotor rhinitis, Vidian neurectomy has given complete relief in 94 percent of the patients sustained throughout five to 15‐year follow‐up. The operation has proved valuable in most cases with additional evidence of atopy, but the incidence of complete relief falls to 57 percent. Occasional indications in other conditions are discussed with the results obtained. The need for both meticulous case selection and impeccable technique is stressed. Given these, there now seems no significant risk of material complication. Incautious use of an unsuitable probe for diathermy in the pterygoid canal can give 2 percent risk of serious ophthalmoplegia. Such risk is eliminated by proper use of the author's shouldered probes.

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