Treatment of Chronic Vasomotor Rhinitis with Clinico-Pathological Study of Vidian Nerve Section in 150 Cases

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

“…Ten studies (470 patients) reported a mean follow-up time of 33.59 months (SD = 31.78) 4 10 , 13 , 18 , 19 , 22 , 26 , 39 , 40 , 44 Seven studies did not report follow-up time.…”

“…, 18 , 20 – 22 , 24 , 29 , 34 , 39 , 41 Nasal symptoms on which diagnoses were based were detailed in 13 studies (40.63 per cent) 13 19 , 24 , 25 , 28 – 30 , 35 , 36 , 39 , 42 – 44 Eight studies (25 per cent) reported on poor response to pre-operative treatment: intranasal corticosteroids or oral antihistamines (six studies), 9 , 10 , 12 , 13 , 23 , 25 immunotherapy (one study), 23 and septoplasty or inferior turbinate surgery (one study) 43 . A good response to anticholinergic nasal spray was reported in one study, and served as an indication for surgery (vidian neurectomy) 4 .…”

“…performed endoscopic vidian neurectomy using transnasal and trans-sphenoidal approaches. In 20 studies, surgery was performed under direct vision or with the assistance of a microscope using different approaches: transantral (12 studies), 27 , 29 , 32 – 36 , 38 , 40 , 41 , 43 , 44 transnasal (5 studies), 23 , 25 , 28 , 30 , 31 transpalatal (2 studies) 37 , 42 and transseptal (1 study) 39 …”

“…Seventeen studies reported on objective findings ( n = 748) 9 10 , 12 , 13 , 19 – 21 , 24 , 26 , 29 , 33 , 34 , 37 , 39 – 41 , 44 In nine studies, objective findings were the primary outcome (Table V). 12 , 24 , 26 , 29 , 33 , 37 , 39 , 41 , 44 …”

“…Histological changes in the nasal mucosa were examined in four studies ( n = 210) 20 21 , 37 , 44 All four studies reported post-operative decreases in cellular infiltration and in the number of glands in the nasal mucosa. Two studies reported a decrease in mucosal oedema 37 …”