以腭鞘管为指引的高选择性翼管神经切断术的临床观察

Clinical observation of highly selective vidian neurectomy guided by the palatovaginal canal

目的:探讨以腭鞘管为指引进行高选择性翼管神经切断术的安全性及可行性。方法:对53例常年性变应性鼻炎(PAR)患者进行低温等离子手术治疗,在低温等离子辅助下切除腭骨蝶突前的软组织,寻找腭鞘管切断管内血管神经后暴露翼管前口,切断翼管神经。结果:53例PAR患者接受本术式治疗,术中未损伤蝶腭动脉主干,术后无继发性出血及腭部麻木感,患者鼻塞、喷嚏、流涕、鼻痒症状较术前明显好转。结论:以腭鞘管为指引的高选择性翼管神经切断术手术进路相对简便、安全,可为耳鼻喉专科医生提供参考。

Objective:Summarize the safety and feasibility of highly selective vidian neurectomy guided by the palatovaginal canal.Methods:Hypothermal plasma surgery was performed on 53 patients with perennial allergic rhinitis(PAR).Remove the soft tissue covering the anterior wall of the sphenoid process of palatine bone using the Coblation system.Find the palatovaginal canal and cut off the neurovascular bundle in the palatovaginal canal.Expose the anterior orifice of the vidian canal and cut off the vidian nerve.Results:53 PAR patients have conducted the novel vidian neurectomy without sphenopalatine artery trunk damage.No secondary hemorrhage and hard palate numbness happened.The symptoms of nasal obstruction,sneeze,nasal discharge,and rhinocnesmus were relieved significantly.Conclusion:The simple and safe approach of highly selective vidian neurectomy guided by the palatovaginal canal provides an alternative surgical option for clinicians.