鼻内窥镜下翼管神经切断术对血管运动性鼻炎的治疗作用

Therapeutic effect of vadian neurectomy under the nasal endoscope on the vasomotor rhinitis

目的:探讨鼻内窥镜下翼管神经切断术对血管运动性鼻炎的治疗作用,方法:对14个尸头进行细致的解剖测量研究,并对51例血管运动性鼻炎患者实施了鼻内窥镜下切除中鼻甲后端进路的翼管神经切断术,术后随访5年。结果:解剖测量显示,翼管位于蝶腭孔的后方,外口呈漏斗型,垂直径为(3.5±0.9)mm,横径为(2.9±0.5)mm,距离圆孔为(6.1±1.2)mm,距离鼻中隔(10.5±5.9)mm。翼管的纵轴与水平面成角(27±9.6)度,与矢状平面成角(7.8±2.5)度。51例病人的随访结果显示,术后5年内显效病例为41例(80.4%),有效病例3例(5.9%)。结论:鼻内窥镜下切除中鼻甲后端进路的翼管神经切断术,是治疗血管运动性鼻炎的有效方法。

Objective To explore the therapeutic effect of vadian neurectomy under the nasal endoscope on the vasomotor rhinitis. Methods Anatomic measurements of vadian canal in 14 cadavers were carried out, and vadian neurectomy under the nasal endoscope was performed on 51 patients with vasomotor rhinitis. Results Anatomic measurements showed vadian canal was located behind the sphenoid-palatine hole, and its external orifice was shaped as infundibular. The vertical di- ameter was （3.5±0.9） mm and the horizontal diameter was （2.9±0.5） mm. The distance to the rotundum foramen and nasal septum was （6. 1±1.2） mm and （10.5±5.9） mm. Longitudinal axes of the vadian canal was （27.0±9.6） degrees with the horizontal plane, and （7. 8±2.5 ） degree with the sagittal plane. Among the 51 patients, 41 （ 80.4 % ） patients showed complete response and 3 （ 5.9% ） partial response at the 5 -year follow-up. Conclusion Vadian neurectomy under nasal endoscope is an effective technique for vasomotor rhinitis.