Clinical Analysis Of Unilateral Vidian Neurotomy Under Nasal Endoscopy Assisted By Image Guidance

Objective:To explore the clinical value of unilateral vidian neurotomy under nasal endoscopy assisted by image guidance in the treatment of moderate-severe allergic rhinitis.Methods:The clinical data of 82 patients who were mainly diagnosed as moderate-severe allergic rhinitis in the otorhinolaryngological department of the Second Hospital of Shanxi Medical University from 2016.2 to 2017.12 were retrospectively analyzed.According to the different auxiliary methods,the patients were divided into the guidance group(50 cases)and the non guidance group(32 cases).The guidance group carried out the endoscopic surgery under the image guidance,the non guidance group carried out the traditional endoscopic surgery.By comparing the anesthesia time(AT),operation time(OT),intraoperative bleeding volume(BA),intraoperative complications,postoperative complications and postoperative nasal cavity comfort degree to assess the differences of the two groups operation.Separate calculated and compared the difference of the total visual analogue scale(VAS)score between the preoperative and postoperative three months as well as six months in the guidance group and the non guidance group to assess the difference of the subjective nasal condition between the two groups patients.Calculated and compared the difference of tear secretion test between the preoperative and postoperative three days in the guidance group and the non guidance group to assess the difference between the two groups operation results.Results:1.Through statistical analysis of 82 cases of complete data,the anesthesia time,operation time and bleeding volume of the guidance group were significantly lower than those in the non guidance group,all the P value was less than 0.05,and the difference was statistically significant.2.Compared the difference of the total VAS scores between the preoperative and postoperative three months as well as six months in the guidance group and the non guidance group,all the P value was greater than 0.05,and the difference was not statistically significant.3.Compared the difference of tear secretion test between the preoperative and postoperative three days in the guidance group and the non guidance group,all the P value was greater than 0.05,and the difference was not statistically significant.4.In the comparison of intraoperative and postoperative complications between the guidance group and the non guidance group,all the P value in the intranasal complications was less than 0.05,and the difference was statistically significant;all the P value in the intraorbital complications was greater than 0.05,and the difference was not statistically significant;no intracranial complications happened.5.In the nasal cavity comfort degree comparison of postoperative three months between the guidance group and the non guidance group,the P value was less than 0.05,and the difference was statistically significant;In the nasal cavity comfort degree comparison of postoperative six months between the guidance group and the non guidance group,the P value was greater than 0.05,and the difference was not statistically significant.Conclusion:Using image guidance technique to assist nasal endoscopic unilateral vidian neurotomy can quickly confirm the anatomical structure,realize the precise location of the vidian,reduce the anesthesia time,the operation time,intraoperative bleeding volume,the intraoperative and postoperative complications and the secondary injury,save the medical cost and realize the precision medical.It is the development direction of endoscopic sinus surgery in the future,but the application of image guidance technology can not improve the curative effect of patients.It is only an auxiliary tool.