Endoscopic posterior nasal neurectomy: an alternative to Vidian neurectomy

Although Vidian neurectomy is very effective as a means of alleviating symptoms of chronic rhinitis (allergic rhinitis and vasomotor rhinitis), it is presently seldom used because of a high incidence of complications such as disturbed lacrimal secretion and sensory disorders of the cheek and gum. In 1997, Kikawada succeeded in endoscopically cutting the posterior nasal nerve (a ramus of the Vidian nerve) at the level of the sphenopalatine foramen under clear vision. This technique has since been improved into one that allows safe and rapid completion of the operation using a bipolar device. This new technique of endoscopic posterior nasal neurectomy with a bipolar device will be presented in this paper.