A systematic review of the evidence base for vidian neurectomy in managing rhinitis

Marshak, Tal; Yun, Wang; Hazout, C; Sacks, Raymond; Harvey, Richard J.

doi:10.1017/s0022215116008008

Cited by 43 publications

(50 citation statements)

References 49 publications

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“…Interestingly, our experience parallels that reported in the literature on functional outcomes of vidian neurectomy for incoercible rhinitis. A recent review analyzing 16 studies reported a dry eye condition in 23.96% (276/1,152) of patients . A subanalysis limited to eight studies, also addressing the duration of dry eye symptoms, found that they were temporary in 96.46% of patients (218/226) and spontaneously resolved within 6 months …”

Section: Discussionmentioning

confidence: 99%

“…review analyzing 16 studies reported a dry eye condition in 23.96% (276/1,152) of patients. 13 A subanalysis limited to eight studies, also addressing the duration of dry eye symptoms, found that they were temporary in 96.46% of patients (218/226) and spontaneously resolved within 6 months. 13 The analysis of sensitivity impairment provided more complex results.…”

Section: Discussionmentioning

confidence: 99%

“…13 A subanalysis limited to eight studies, also addressing the duration of dry eye symptoms, found that they were temporary in 96.46% of patients (218/226) and spontaneously resolved within 6 months. 13 The analysis of sensitivity impairment provided more complex results. At the level of the buccal, alveolar ridge, and premaxillary regions, the threshold of sensitivity between the treated and untreated sides was comparable, which suggests that the buccal, superior alveolar, and infraorbital nerves, respectively, were preserved.…”

Section: Discussionmentioning

confidence: 99%

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Long‐term neurological morbidity following endoscopic transnasal resection of juvenile angiofibroma

Mattavelli¹,

Rampinelli²,

Ferrari³

et al. 2018

The Laryngoscope

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Objectives/Hypothesis Although transnasal endoscopic resection (TER) of juvenile angiofibroma (JA) is unquestionably less invasive than traditional external approaches, several endonasal and neurovascular structures are sacrificed during the procedure. The aim of this study was to evaluate long‐term neurological morbidity and related quality of life following TER of JA. Study Design Retrospective cohort study. Methods All patients who underwent TER for JA at the Unit of Otorhinolaryngology–Head and Neck Surgery of the University of Brescia from 1994 to 2016 were contacted to know their availability to undergo a battery of tests aimed to assess lacrimal secretion (Schirmer test), impairment of sensitive nerves (electrophysiological threshold test), and impact on quality of life of tearing reduction and sensitivity impairment with the Ocular Surface Disease Index (OSDI) and visual analogue scale (VAS) (0–10), respectively. Results Thirteen patients were included. Mean follow‐up was 77 months (range, 19–156 months). The median Schirmer test value was 5.5 mm and 28.5 mm for the treated and untreated sides, respectively (P = .003). Analysis of sensitivity revealed significant impairment only in the hard palate. The mean OSDI score was 6.8 (normal). The mean values of the VAS scores for hard palate, buccal mucosa, gum, and premaxillary skin were 1.7, 1.7, 1.2, and 2.3, respectively. Conclusions TER for JA can result in objective reduction of lacrimal secretion and sensitivity impairment; nevertheless, their impact on quality of life is negligible. The predictable neurological morbidity of TER should be discussed during preoperative counseling. Level of Evidence 4 Laryngoscope, 129:2184–2188, 2019

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Long‐term neurological morbidity following endoscopic transnasal resection of juvenile angiofibroma

Mattavelli¹,

Rampinelli²,

Ferrari³

et al. 2018

The Laryngoscope

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“…The evolution of endoscopic skull‐base surgery combined with improved understanding of the anatomy and function of the vidian nerve has led to a resurgence of interest in the procedure of vidian neurectomy . The procedure was very popular in the 1970s and 1980s before it lost favor because of reports of complications and questions regarding long‐term efficacy .…”

Section: Vidian Neurectomymentioning

confidence: 99%

“…Vidian neurectomy has been described for treating symptoms of allergic, nonallergic, and mixed rhinitis refractory to medical therapy . In particular, several authors describe its utilization in intractable vasomotor rhinitis, a form of chronic rhinitis that is characterized by watery rhinorrhea presumed to be resulting from an imbalance of parasympathetic and sympathetic input to the nose .…”

Section: Vidian Neurectomymentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

151

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis

Wise

Lin

Toskala

et al. 2018

Int Forum Allergy Rhinol

336

453

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This critical review of the AR literature has identified several strengths; providers can be confident that treatment decisions are supported by rigorous studies. However, there are also substantial gaps in the AR literature. These knowledge gaps should be viewed as opportunities for improvement, as often the things that we teach and the medicine that we practice are not based on the best quality evidence. This document aims to highlight the strengths and weaknesses of the AR literature to identify areas for future AR research and improved understanding.

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A systematic review of the evidence base for vidian neurectomy in managing rhinitis

Abstract: Endoscopic vidian neurectomy does have a role in the surgical management of refractory rhinitis, particularly in patients with non-allergic rhinitis, but a well-designed cohort trial would be advantageous to clarify long-term outcomes.

Cited by 43 publications

References 49 publications

Long‐term neurological morbidity following endoscopic transnasal resection of juvenile angiofibroma

Long‐term neurological morbidity following endoscopic transnasal resection of juvenile angiofibroma

ICAR: endoscopic skull‐base surgery

International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis

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