[Endoscopic anatomy of palatovaginal canal and its application in posterior nasal neurectomy].

Objective

To identify reliable anatomical landmarks through endoscopic dissection of the palatovaginal canal（PVC） and to introduce a novel posterior nasal neurectomy（PNN） approach via this canal, while evaluating its clinical efficacy in allergic rhinitis（AR）.

Methods

Surgical-route dissection was performed on 10 dry skulls and 2 fresh cadaveric heads to obtain high-definition images of the PVC region. A retrospective analysis was conducted on 30 AR patients who underwent PNN in which the PVC served as the key landmark. Symptom severity was assessed with a visual analogue scale（VAS） pre-operatively and 12 months post-operatively.

Results

Critical landmarks for the new approach were identified, including the sphenoidal process of the palatine bone, posterior aperture of the PVC, posterior sulcus, PVC itself, vomerovaginal canal, vaginal process, and sphenopalatine foramen. One year after surgery, mean VAS scores for nasal obstruction, itching, sneezing, rhinorrhea, and overall discomfort were all lower than baseline with statistically significant differences. Aside from transient palatal numbness in five patients, no other complications occurred.

Conclusion

Endoscopic PNN via the palatovaginal canal is a safe and effective surgical method for the treatment of allergic rhinitis.