[The clinico-anatomical basis for sectioning the vidian nerve]

Area of Science:

• Otorhinolaryngology
• Neurosurgery
• Medical Imaging

Background:

• Chronic polypous rhinosinusitis significantly impacts nasal mucosa health and patient quality of life.
• The vidian nerve plays a role in autonomic innervation influencing nasal secretions and inflammation.
• Current treatments for chronic rhinosinusitis have limitations in achieving persistent symptom control.

Purpose of the Study:

• To evaluate the efficacy and safety of the Nomure transantral subperiosteal approach for vidian nerve sectioning.
• To assess the utility of laser nerve destruction in preventing postoperative complications.
• To determine the effectiveness of vidian nerve sectioning in managing chronic polypous rhinosinusitis.

Main Methods:

• Anatomical study of the pterygopalatine fossa using cadavers, angiography, and X-ray tomography.
• Laser parameters for vidian nerve destruction were optimized in animal models (white rats).
• Seventy surgical interventions were performed utilizing the Nomure approach with laser vidian nerve destruction.

Main Results:

• The Nomure transantral subperiosteal approach demonstrated advantages for accessing the vidian nerve.
• Laser destruction of the vidian nerve was effective in preventing postoperative complications.
• Surgical interventions resulted in persistent symptom response and improved nasal mucosa condition in patients.

Conclusions:

• Vidian nerve sectioning using the Nomure approach with laser ablation is an effective treatment for chronic polypous rhinosinusitis.
• This surgical technique offers a persistent therapeutic response and improves the condition of the nasal mucosa.
• The study supports the Nomure approach as a valuable option for managing refractory chronic rhinosinusitis.