文献的考察と手術手技について

抄録

Basic and clinical aspects of vidian neurectomy were mentioned by reviewing available medical literatures. Symptoms of chronic vasomotor rhinitis and allergic rhinitis are produced by cholinergic nerve stimulation. In the latter case, allergic reaction in the nasal mucous membrane could be a trigger which stimulates afferent fiber first and eventually the cholinergic efferent fiber to the nasal gland and vessels. Vidian neurectomy brings about a dramatic relief of symptoms in intractable cases of chronic vasomotor rhinitis as well as allergic rhinitis, as the nerve is the main route of cholinergic nerve fiber to the nose. A new transantral approach to the vidian nerve is described in details. Different from the conventional transantral approach, the new transantral subperiosteal vidian neu-rectomy does not require dissection of the content of the retroantral space. The canal is reached subperiosteally upward from the sphenomaxillary surface of the sphenoid. The vidian nerve is sectioned after electrocauterization within the canal. Therefore, the opera-tive procedure is less traumatic to the tissues in the retroantral space which contains the pterygopalatine ganglion and branches of the maxillary artery. No hazardous complica-tion has been encountered.