How do we measure disease control in CRS (and why we need to)

LECTURE PROPOSAL

title: endoscopic transnasal vidian neurectomy and pterygopalatine fossa anatomy

authors:       

1. Assoc. Prof. Ercan akbay, MD

department of otorhinolaryngology, aksaray i̇nova hospital, aksaray, turkey

2.     sümeyye akbay

anatomy postgraduate student

format & duration: video presentation

abstract

background & objectives: vasomotor rhinitis (VMR) is a non-allergic chronic rhinitis characterized by vascular dysfunction within the nasal cavity and autonomic nervous system imbalance. In cases of medically refractory and resistant VMR, endoscopic transnasal vidian neurectomy—an advanced autonomic denervation surgery—is performed to control hypersecretion and vasodilation. This video presentation aims to demonstrate the vidian neurectomy surgical procedure guided by anatomical landmarks, and to discuss the deep anatomical structures of the pterygopalatine fossa, vidian nerve, and paranasal region from a surgical perspective.

surgical technique & methods: the procedure is performed endoscopically under general anesthesia. Following the identification of the lateral nasal wall landmarks, a mucoperiosteal flap is elevated to access the sphenopalatine foramen. Precise dissection is required to expose the medial boundary of the pterygopalatine fossa. Upon localization of the vidian canal (canalis pterygoideus), the vidian nerve—comprising fibers from the nervus petrosus major and nervus petrosus profundus—is identified. Selective neurectomy is performed at this level, followed by measures to ensure the stability of the surgical site and prevent neural regeneration. The procedure concludes with the repositioning of the mucosal flap and appropriate stabilization.

conclusion & significance: this video presentation provides a comprehensive, step-by-step demonstration of endoscopic transnasal vidian neurectomy. By highlighting the critical anatomical landmarks of the pterygopalatine fossa, this work aims to contribute to the surgical success and safety of autonomic denervation procedures. It serves as a practical anatomical guide for clinicians managing refractory vasomotor rhinitis.

assoc. Prof. Ercan akbay, MD

aksaray i̇nova hastanesi kulak burun boğaz kliniği, aksaray, turkey

+90 5543429131

[email protected]

I have any videos about surgical procedure on nasal cavity and paranasal sinuses such as, endoscopic DCR, choanal atresia elimination, tumors removal (estezionoroblastoma, inverted papilloma etc), polyps surgery, external nose partial reconstruction with conchal flap mucosa and cartilage graft

Advances in minimally invasive surgery and a deeper understanding of turbinate physiology have led to a more conservative approach in manipulating these structures, focusing on preserving turbinate mucosa while reducing airway resistance and improving sinus fuction.