The method of laser photocoagulation of the peripheral branches of the Vidian nerve is carried out endoscopically using an endonasal approach. However, endoscopic landmarks for localizing the peripheral branches of the vidian nerve are not well described. This study was aimed at creating and analyzing three-dimensional models of the nasal cavity to study the anatomy of the peripheral branches of the Vidian nerve and to determine the endoscopic endonasal approach during laser photocoagulation of the peripheral branches of the Vidian nerve using three-dimensional reconstruction of scanned images of computed tomography.

The aim of this study was to create and analyze three-dimensional models of the nasal cavity to determine endoscopic endonasal access during laser photocoagulation of the distal branches of the vidian nerve.

Materials and methods. X-ray computed tomograms of the nose and paranasal sinuses of 12 patients were prospectively evaluated. The morphology of the wedge-palatine foramen, posterior parts of the middle nasal passage, the place of attachment of the inferior turbinates to the lateral wall of the nasal cavity, the region of the ethmoidal crest (crista ethmoidalis) of the perpendicular plate of the palatine bone, as well as the spatial relationships between them were measured on a three-dimensional model and the endoscopic endonasal access with laser photocoagulation of the peripheral branches of the vidian nerve.

Results. The average distance between the ethmoidal crest (crista ethmoidalis) and the posterior end of the inferior turbinate was 0.5 ± 0.2 cm – a conditional horizontal line. The average distance from the wedge-palatine foramen to the posterior end of the inferior turbinate was 0.7 ± 0.1 cm – a conditional diagonal line. The point of intersection of these lines corresponded to the exit point of the distal branches of the Vidian nerve. The diameter of the wedgepalatine opening is 0.3 ± 0.1 cm.

Conclusions. Endoscopic endonasal access with laser photocoagulation of the peripheral branches of the vidian nerve will be performed with greater accuracy and safety by understanding the spatial relationship between the ethmoid crest of the perpendicular plate of the palatine bone and the posterior end of the inferior turbinate, as well as the wedge-palatine foramen and the posterior end of the inferior turbinate.

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