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Endoscopic posterior nasal neurectomy

Published online by Cambridge University Press:  23 August 2019

N Ahilasamy  and
K Rajendran Dinesh
N Ahilasamy
Affiliation:
Ahilasamy ENT Centre, Chennai, India
K Rajendran Dinesh*
Affiliation:
Department of ENT and Head-Neck Surgery, Hinduja Sindhi Hospital, Bengaluru, India
*
Author for correspondence: Dr Rajendran Dinesh Kumar, Department of ENT and Head-Neck Surgery, Hinduja Sindhi Hospital, Bengaluru 560027, Karnataka, India E-mail: dinuraj1186@gmail.com
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Abstract

Background

Surgical techniques for resistant chronic rhinitis (rhinorrhoea) vary, ranging from vidian neurectomy to post-nasal neurectomy. The techniques vary mainly on the basis of instrumentation, and the avoidance of post-operative epistaxis, transient hypoesthesia of the soft palate and dryness of the eye. Endoscopic visualisation, and cauterisation or resection of posterior nasal nerve branches, can prevent such complications.

Method

The technique and surgical steps of endoscopic posterior nasal neurectomy are presented.

Results

The critical steps include: bilateral sphenopalatine nerve blocks, transnasally or transorally via the greater palatine foramen; vertical incisions made behind the posterior fontanelle; and elevation of the mucoperiosteal flap. The sphenopalatine foramen and artery is identified. The posterior nasal nerve is located 4–5 mm inferior to the sphenopalatine artery, and is resected or cauterised. The flaps are repositioned back into place. No post-operative nasal packing is required. The same procedure is performed on the opposite side for effective results.

Conclusion

This technique provides consistent, robust results, with long-term relief of allergic and vasomotor rhinitis related nasal symptoms, without risk of complication.

Keywords

Rhinitis, AllergicRhinitis, VasomotorPosterior Nasal NerveEndoscopicNeurectomy
Type
Short Communication
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 9 , September 2019 , pp. 825 - 829
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr R D Kumar takes responsibility for the integrity of the content of the paper

References

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