Endoscopic vidian neurectomy

The value of preoperative computed tomographic guidance

Shao Cheng Liu, Hsing Won Wang, Wan Fu Su

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objective: To explore the vidian nerve anatomy by endoscopy and paranasal sinus computed tomography (CT) to elucidate the appropriate surgical approach based on preoperative CT images. Design: Retrospective analysis. Setting: Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China. Patients: Sixty-seven patients underwent 106 endoscopic vidian neurectomies between January 9, 2006, and June 30, 2009. Main Outcome Measures: Paranasal sinus CT had been performed in all patients 2 weeks before surgery. Preoperative surgical planning was based on CT images, which were compared with intraoperative endoscopic findings. Two endoscopic approaches were used for vidian nerve transection, and the success rates were recorded for each. Results: The transsphenoidal approach was successful on 42 sides (39.6%), while the transnasal approach was successful on 91 sides (85.8%). Success rates for the transsphenoidal approach were 0.0%, 72.1% (31 of 43 sides), and 84.6% (11 of 13 sides) for canal corpus types 1, 2, and 3, respectively. Success rates for the transsphenoidal approach were 50.0% (28 of 56 sides), 51.9% (14 of 27 sides), 0.0%, and 0.0% for canal floor relationship types 1, 2, 3, and 4, respectively. The transsphenoidal approach was successful only in patients without an embedded canal and with a canal floor relationship type 1 or type 2. Presence of the septum and continuation of the canal bony structure also influenced the choice of surgical approach. Conclusions: The vidian nerve can be precisely identified and microinvasively transected using endoscopy. Preoperative CT images delineate the vidian canal and enhance preoperative surgical planning.

Original languageEnglish
Pages (from-to)595-602
Number of pages8
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume136
Issue number6
DOIs
Publication statusPublished - Jun 2010
Externally publishedYes

Fingerprint

Tomography
Paranasal Sinuses
Taiwan
Endoscopy
General Hospitals
Anatomy
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

Cite this

Endoscopic vidian neurectomy : The value of preoperative computed tomographic guidance. / Liu, Shao Cheng; Wang, Hsing Won; Su, Wan Fu.

In: Archives of Otolaryngology - Head and Neck Surgery, Vol. 136, No. 6, 06.2010, p. 595-602.

Research output: Contribution to journalArticle

@article{9ded9ccb7f2743c697de65d203f5febf,
title = "Endoscopic vidian neurectomy: The value of preoperative computed tomographic guidance",
abstract = "Objective: To explore the vidian nerve anatomy by endoscopy and paranasal sinus computed tomography (CT) to elucidate the appropriate surgical approach based on preoperative CT images. Design: Retrospective analysis. Setting: Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China. Patients: Sixty-seven patients underwent 106 endoscopic vidian neurectomies between January 9, 2006, and June 30, 2009. Main Outcome Measures: Paranasal sinus CT had been performed in all patients 2 weeks before surgery. Preoperative surgical planning was based on CT images, which were compared with intraoperative endoscopic findings. Two endoscopic approaches were used for vidian nerve transection, and the success rates were recorded for each. Results: The transsphenoidal approach was successful on 42 sides (39.6{\%}), while the transnasal approach was successful on 91 sides (85.8{\%}). Success rates for the transsphenoidal approach were 0.0{\%}, 72.1{\%} (31 of 43 sides), and 84.6{\%} (11 of 13 sides) for canal corpus types 1, 2, and 3, respectively. Success rates for the transsphenoidal approach were 50.0{\%} (28 of 56 sides), 51.9{\%} (14 of 27 sides), 0.0{\%}, and 0.0{\%} for canal floor relationship types 1, 2, 3, and 4, respectively. The transsphenoidal approach was successful only in patients without an embedded canal and with a canal floor relationship type 1 or type 2. Presence of the septum and continuation of the canal bony structure also influenced the choice of surgical approach. Conclusions: The vidian nerve can be precisely identified and microinvasively transected using endoscopy. Preoperative CT images delineate the vidian canal and enhance preoperative surgical planning.",
author = "Liu, {Shao Cheng} and Wang, {Hsing Won} and Su, {Wan Fu}",
year = "2010",
month = "6",
doi = "10.1001/archoto.2010.72",
language = "English",
volume = "136",
pages = "595--602",
journal = "JAMA Otolaryngology - Head and Neck Surgery",
issn = "2168-6181",
publisher = "American Medical Association",
number = "6",

}

TY - JOUR

T1 - Endoscopic vidian neurectomy

T2 - The value of preoperative computed tomographic guidance

AU - Liu, Shao Cheng

AU - Wang, Hsing Won

AU - Su, Wan Fu

PY - 2010/6

Y1 - 2010/6

N2 - Objective: To explore the vidian nerve anatomy by endoscopy and paranasal sinus computed tomography (CT) to elucidate the appropriate surgical approach based on preoperative CT images. Design: Retrospective analysis. Setting: Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China. Patients: Sixty-seven patients underwent 106 endoscopic vidian neurectomies between January 9, 2006, and June 30, 2009. Main Outcome Measures: Paranasal sinus CT had been performed in all patients 2 weeks before surgery. Preoperative surgical planning was based on CT images, which were compared with intraoperative endoscopic findings. Two endoscopic approaches were used for vidian nerve transection, and the success rates were recorded for each. Results: The transsphenoidal approach was successful on 42 sides (39.6%), while the transnasal approach was successful on 91 sides (85.8%). Success rates for the transsphenoidal approach were 0.0%, 72.1% (31 of 43 sides), and 84.6% (11 of 13 sides) for canal corpus types 1, 2, and 3, respectively. Success rates for the transsphenoidal approach were 50.0% (28 of 56 sides), 51.9% (14 of 27 sides), 0.0%, and 0.0% for canal floor relationship types 1, 2, 3, and 4, respectively. The transsphenoidal approach was successful only in patients without an embedded canal and with a canal floor relationship type 1 or type 2. Presence of the septum and continuation of the canal bony structure also influenced the choice of surgical approach. Conclusions: The vidian nerve can be precisely identified and microinvasively transected using endoscopy. Preoperative CT images delineate the vidian canal and enhance preoperative surgical planning.

AB - Objective: To explore the vidian nerve anatomy by endoscopy and paranasal sinus computed tomography (CT) to elucidate the appropriate surgical approach based on preoperative CT images. Design: Retrospective analysis. Setting: Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China. Patients: Sixty-seven patients underwent 106 endoscopic vidian neurectomies between January 9, 2006, and June 30, 2009. Main Outcome Measures: Paranasal sinus CT had been performed in all patients 2 weeks before surgery. Preoperative surgical planning was based on CT images, which were compared with intraoperative endoscopic findings. Two endoscopic approaches were used for vidian nerve transection, and the success rates were recorded for each. Results: The transsphenoidal approach was successful on 42 sides (39.6%), while the transnasal approach was successful on 91 sides (85.8%). Success rates for the transsphenoidal approach were 0.0%, 72.1% (31 of 43 sides), and 84.6% (11 of 13 sides) for canal corpus types 1, 2, and 3, respectively. Success rates for the transsphenoidal approach were 50.0% (28 of 56 sides), 51.9% (14 of 27 sides), 0.0%, and 0.0% for canal floor relationship types 1, 2, 3, and 4, respectively. The transsphenoidal approach was successful only in patients without an embedded canal and with a canal floor relationship type 1 or type 2. Presence of the septum and continuation of the canal bony structure also influenced the choice of surgical approach. Conclusions: The vidian nerve can be precisely identified and microinvasively transected using endoscopy. Preoperative CT images delineate the vidian canal and enhance preoperative surgical planning.

UR - http://www.scopus.com/inward/record.url?scp=77953881178&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953881178&partnerID=8YFLogxK

U2 - 10.1001/archoto.2010.72

DO - 10.1001/archoto.2010.72

M3 - Article

VL - 136

SP - 595

EP - 602

JO - JAMA Otolaryngology - Head and Neck Surgery

JF - JAMA Otolaryngology - Head and Neck Surgery

SN - 2168-6181

IS - 6

ER -