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

Published online by Cambridge University Press:  04 August 2016

T Marshak ,
W K Yun ,
C Hazout ,
R Sacks  and
R J Harvey
T Marshak*
Affiliation:
Rhinology and Skull Base, Applied Medical Research Centre, University of New South Wales, Sydney, Australia Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
W K Yun
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Concord General Hospital, University of Sydney, Australia
C Hazout
Affiliation:
Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
R Sacks
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Concord General Hospital, University of Sydney, Australia Department of Otolaryngology, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
R J Harvey
Affiliation:
Rhinology and Skull Base, Applied Medical Research Centre, University of New South Wales, Sydney, Australia Department of Otolaryngology, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
*
Address for correspondence: Dr Tal Marshak, Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya 22100, Israel Fax: +972 4 910 7671 E-mail: talmarshak@yahoo.com
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Abstract

Background:

Vidian neurectomy has been proposed as a surgical option for rhinitis refractory to medical treatment. However, the evidence base for its benefit remains controversial.

Methods:

A systematic review was performed. Studies reporting original data on patients with rhinitis treated by vidian neurectomy were included. Patient-reported outcome measures were the primary outcome investigated; specific peri-operative morbidities were the secondary outcome.

Results:

A total of 1012 articles fulfilled the search criteria, 32 of which were included in the study. Patient-reported outcome measures were compared before and after surgery in eight studies. There were 529 patients represented in these trials. Significant improvement in rhinorrhoea was reported in all eight studies. Temporary dry eyes was reported in 24.63 per cent of cases (272 out of 1104 cases). There was no report of cranial nerve deficit or eye movement disturbance.

Conclusion:

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.

Keywords

RhinitisAllergicPerennial; RhinitisAllergicSeasonal; RhinitisAtrophic; RhinitisVasomotor; Vidian; Neurectomy
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Supplement S4 , July 2016 , pp. S7 - S28
Copyright
Copyright © JLO (1984) Limited 2016 

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Footnotes

Presented at the 61st American Rhinologic Society annual meeting, 26 September 2015, Dallas, Texas, USA.

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