Graft Reinforcement for Posterior Nasal Nerve Neurectomy in Allergic Rhinitis Surgeries

"A vertical incision is made behind the posterior fontanelle. The posterior end of the posterior fontanelle is identified by palpation with an elevator. .~The mucoperiosteum is raised gently using a Cottle elevator or a suction freer elevator, after making the initial incision. Care must be taken not to injure the sphenopalatine vessel during flap elevation.~The peripheral part of the posterior nasal nerve can usually be identified just behind the incision, about 4-5 mm inferior to the sphenopalatine artery or crista ethmoidalis.~I After identifying the nerve fibres, it is cauterised using monopolar suction cautery and cut using microscissors. It is essential to carry out this procedure on both sides for effective results."

"A vertical incision is made behind the posterior fontanelle. The posterior end of the posterior fontanelle is identified by palpation with an elevator. .~The mucoperiosteum is raised gently using a Cottle elevator or a suction freer elevator, after making the initial incision. Care must be taken not to injure the sphenopalatine vessel during flap elevation.~The peripheral part of the posterior nasal nerve can usually be identified just behind the incision, about 4-5 mm inferior to the sphenopalatine artery or crista ethmoidalis.~I After identifying the nerve fibres, it is cauterised using monopolar suction cautery and cut using microscissors. It is essential to carry out this procedure on both sides for effective results.~then harvest cartilage from nasal septum and refashion it around sphenopalatine bundle to prevent nerve re-innervation~The mucoperiosteal flaps are repositioned . No nasal packing is required. Patients are discharged on the same day"