Vidian Neurectomy: A Narrative Review

Vidian neurectomy (VN) is a surgical procedure that aims to reduce the symptoms of chronic rhinitis or rhinogenic headache by cutting the vidian nerve, which carries parasympathetic fibers to the nasal mucosa. VN has been used for decades as a last resort for patients who do not respond to conservative treatments and have no contraindications for VN, such as allergic rhinitis, atrophic rhinitis, or anatomical variations. VN can effectively reduce nasal symptoms and improve quality of life, especially when combined with other nasal surgeries. However, the evidence for VN is limited and the long-term effects and safety of VN are uncertain. The most common complications of VN are dry eye and facial numbness, which are usually mild and transient. Clinicians should also participate in multicenter studies and registries to contribute to the evidence base for VN and compare it with other modalities, such as posterior nasal nerve ablation or pharmacological agents.