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Zopet lepo pozdravljeni!
Pisal sem vam že večkrat v zvezi z vazomotornim rinitisom ki ga imam že 11 leto. Uglavnem zadeva je pri meni resnično alarmantna predvsem zaradi psiholoških učinkov te nadležne bolezni. Občasno čutim tako močan pritisk v nosu da bi si ga najrajši odrzal če mi verjamete enostavno me ta zadeva psihično uničuje in verjemite mi da ne pretiravm.
Ogromno berem o tem in sem vas že povprašal v zvezi z sekcijo vidianusa, ki jo v strokovni in splošni literaturi omenjajo ravnotako sem prebral da pride v pošetv v določenih primerih kriokirurgija.
Resnično ne zdržim več pa kljub temu da imam občasno dni ko je zadeva pod nadzorom.
Uglavnem kam naj se obrnem da bi potencialno prišel do omenjenih posegov. Za kakršnekoli informacije se vam resnično zahvaljujem.
Najlepša hvala za odgovor.
Vprašanje pa sem postavil na podlagi člankov oz. objav na internetu, ki pa navajajo sledeče:
-Department of Otorhinolaryngology, University of Natal, Durban, South Africa.
Bilateral transnasal vidian neurectomy was performed on 276 patients between 1983 and 1991. The indications for operation were intractable vasomotor rhinitis, resistant allergic rhinitis and recurrent nasal polyposis. Two hundred and fifty-eight patients were contacted and long-term results showed that 88 per cent of the patients had an excellent result.
-Department of Otolaryngology, Tanta University, Egypt.
OBJECTIVE: Evaluation of the endoscopic transseptal approach of vidian neurectomy. DESIGN: A case series, with a follow-up of 12 to 24 months. SETTING: A referral center. PATIENTS: A consecutive sample of 11 adult patients with resistant vasomotor rhinitis: eight with severe rhinorrhea and three with recurrent nasal polyposis. All patients had a negative history of allergy and negative skin tests. All patients completed the study. INTERVENTION: The rigid nasal endoscope was used through a transseptal approach to reach the sphenopalatine foramen and to cut the vidian nerve. MAIN OUTCOME MEASURES: Intraoperative identification and cutting of the vidian nerve under direct endoscopic vision. Postoperative evaluation of rhinorrhea, sneezing, and recurrent disease. RESULTS: The vidian nerve was identified and sectioned bilaterally in all cases. Immediate and complete cessation of rhinorrhea uniformly occurred. Paroxysms of sneezing were vastly reduced. No recurrence was detected, except in one case. Three patients complained of dry eyes, but they had symptomatic relief with artificial teardrops. CONCLUSION: The technique of endoscopic transseptal vidian neurectomy is a minor surgical procedure with high efficacy and minimal postoperative morbidity. More cases and longer follow-up are necessary to provide long-term results.
-ENT Department, Seth G.S. Medical College, Bombay, India.
Vasomotor rhinitis is a frustrating experience both for the consultant and for the patient. The purpose of vidian neurectomy is to destroy the secretomotor nerve supply to the nasal mucosa, the main indication being severe intractable non-atopic vasomotor rhinitis. A review of 208 cases which have undergone transnasal vidian neurectomy by diathermy coagulation in the last five years is presented. The operation has proved worthwhile, the patients remaining symptom-free in 92 per cent of cases (longest follow-up 5 years). There have been no complications.
-Kirtane MV, Prabhu VS, Karnik PP.
Vidian neurectomy is a useful procedure in relieving the symptoms of vasomotor rhinitis. However, the nerve is difficult to approach because of its deep location in the pterygopalatine fossa. A direct transnasal approach to the pterygopalatine fossa, passing through the sphenopalatine foramen in the lateral wall of the nose, is described and its merits are discussed. We have operated upon 247 cases by this approach over the past four years without any significant complications.
-Agarwal PN.
Indications and results of 125 Vidian neurectomies done in 64 patients have been presented. The indications were grouped as: Rhinorrhoea (37.5%), Nasal Polyposis (3.12%); Headaches and Faceaches (45.32%); and Bronchial Asthma (14-06%). Four initial Vidian neurectomies were done unilaterally and produced only partial relief in symptoms. Bilateral Vidian neurectomy relieved completely all the rhinorrhoea cases, all the nasal polyposis cases, 79-3% of headache and faceache cases and 55-5% of bronchial asthma cases.
Uglavnem glede na te rezultate se mi zdi čudno da se ta operacija ne izvaja, verjetno nek razlog obstaja.
Lep pozdrav!