Imaging anatomy of the vidian canal and its clinical significance

Background: Vidian neurectomy (VN) is an effective surgical treatment for severe allergic rhinitis (AR). However, little research has been conducted on the imaging anatomy of the vidian canal (VC). This study aimed to analyze the computed tomography (CT) imaging of the VC and its surrounding structures and investigate the morphometric characteristics and clinical significance of VN. Methods: We analyzed 118 paranasal sinus CT scans (55 male and 63 female patients), with axial, coronal, and sagittal slices being used in the study.Results: Among the 118 patients in this study, the average length of the VC in male and female patients was 14.00 +/- 3.35 and 12.51 +/- 3.42 mm, respectively; the transverse diameter of the posterior segment of the VC in females was larger than that in males; and the length of the VC and the distance between VC and foramen rotundum (FR) in males were longer than those in females. The angle between the VC and the sagittal plane and the angle between the sphenopalatine foramen (SPF) and the VC in females were larger than those in males, and the distance between the attachment to the end of the middle turbinate (MT) and the VC was greater. Type 2 VC occupied a dominant position. The VC was mostly at the same line as the medial wall of the maxillary sinus (MS) and was located on the medial side of the medial pterygoid plate (MPTG). The highest point of the VC was mostly superior to that of the palatovaginal canal (PVC). Most of the VC was inferior to the internal carotid artery (ICA), and no cases were observed in which the VC was above the ICA. Some of the measurements of the VC and its surrounding structures were correlated.Conclusions: The position and morphometric information of the VC could be reflected in a CT scan, which may contribute to the evaluation of VN preoperatively and postoperatively.