Vidian nerve

• Region-specific Brain Targets Drive Circuit Formation and Maturation of Human Retinal Ganglion Cells
• Endoscopic Transorbital Extended Middle Fossa Approach: A Potential Addition to the Lateral Skull Base Surgical Armamentarium-Anatomic Feasibility Study
• Co-delivery of neurotrophic factors and a zinc chelator substantially increases retinal ganglion cell survival and axon protection in the optic nerve crush model
• Structure-function correlates in anterior visual pathway lesions: a systematic review
• Islet-2 Is Required for the Survival of Islet-Expressing Retinal Ganglion Cells but Not for Their Pathfinding to the Contralateral Dorsal Lateral Geniculate Nucleus
• Citicoline and Coenzyme Q10: Therapeutic Agents for Glial Activation Reduction in Ocular Hypertension
• Microglia remodeling in the visual thalamus of the DBA/2J mouse model of glaucoma
• Transorbital endoscopic approach for repair of a lateral sphenoid sinus cerebrospinal fluid leak

The vidian nerve, also known as the nerve of the pterygoid canal, is a mixed nerve carrying both parasympathetic and sympathetic fibers. It plays a crucial role in the autonomic innervation of structures in the head, particularly in the nasal mucosa and lacrimal gland.

Origin:

Formed by the union of:

Greater petrosal nerve: Carries parasympathetic fibers from the facial nerve (CN VII).

Deep petrosal nerve: Carries sympathetic fibers from the internal carotid plexus.

The vidian nerve travels through the pterygoid canal within the sphenoid bone.

It reaches the pterygopalatine ganglion (located in the pterygopalatine fossa).

Parasympathetic fibers synapse in the pterygopalatine ganglion, while sympathetic fibers pass through without synapsing.

Parasympathetic Fibers:

Originate from the superior salivatory nucleus (via the facial nerve).

Synapse in the pterygopalatine ganglion and provide secretomotor innervation to:

Lacrimal glands: Stimulate tear production.

Nasal glands: Stimulate mucus secretion.

Palatal glands.

Sympathetic Fibers:

Originate from the superior cervical ganglion.

Do not synapse in the pterygopalatine ganglion.

Cause vasoconstriction of blood vessels in the nasal mucosa and surrounding areas.

Involvement in Disease:

Chronic Rhinitis: Overactivity of parasympathetic fibers can lead to excessive nasal secretions.

Cluster Headaches and Migraines: Parasympathetic overactivation in the vidian nerve pathway is implicated in some cases.

Surgical Consideration:

Vidian Neurectomy: A surgical procedure to transect the vidian nerve to manage refractory rhinorrhea or vasomotor rhinitis.

CSF Leaks:

The vidian canal's proximity to the sphenoid sinus makes it an important landmark in skull base surgeries.

Imaging:

The vidian nerve can be visualized in CT or MRI scans, particularly when evaluating pathologies in the pterygoid canal or pterygopalatine fossa.

The vidian nerve is an essential component of autonomic regulation in the head and neck, and understanding its anatomy and function is critical for diagnosing and managing conditions related to parasympathetic or sympathetic dysregulation.

In the anterior genu/foramen lacerum segment of the ICA, the vidian nerve is an important landmark.

The vidian canal (VC), a bony tunnel in which the vidian artery and vidian nerve pass, has been widely known as an important landmark to identify the anterior genu of the petrous carotid artery (AGPCA) especially during lateral extended endoscopic endonasal approachs (LEEEAs).