Vidian neurectomy — Some technical remarks

This paper describes a new surgical technique of vidian neurectomy. Although the vidian canal is approached transantrally, it differs from the conventional technique in that this procedure does not require dissection of the pterygopalatine fossa. The maxillary sinus is opened, using Caldwell‐Luc's procedure; a U‐shaped mucosal incision is made and lifted up, exposing the posterior bony wall as well as a posterior part of the medial bony wall of the antrum. After removing the bony wall, the periosteum covering the pterygopalatine fossa and the nasal mucosa (underside) are revealed. There is a crevice between these soft tissues. The maxillary surface of the sphenoid can be easily touched by a small periosteal elevator inserted into the crevis. The medial corner of the pterygopalatine fossa is pushed aside laterally with the covering periosteum. This exposes a part of the bony surface of the maxillary surface of the sphenoid. Go upward, touching on the maxillary surface until the elevator goes into the funnel‐like opening of the vidian canal. The content of the vidian canal is electrocauterized and sectioned. It is important to expose the whole circumference of the bony opening of the vidian canal. This guarantees the complete section of the vidian nerve. The canal is plugged with a piece of gelatine sponge and bone wax. The mucosal flap is returned back. This surgical procedure may be properly termed as “Transantral Subperiosteal Vidian Neurectomy.”