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However, the evidence bases for its benefit remain debatable. In this study, we conducted a systematic review and meta\u2010analysis to clarify the therapeutic role of various forms of vidian neurectomy in refractory AR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Preferred Reporting Items for Systematic Reviews and Meta\u2010analyses guidelines were used to conduct a systematic review of primary studies that reported original patient data for endoscopic vidian neurectomy (EVN) and vidian\u2010branch neurectomy, which includes selective vidian neurectomy (SVN) and posterior nasal neurectomy (PNN). The primary outcome was patient\u2010reported outcome measures (PROMs), including the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and Visual Analog Scale (VAS), to assess an improvement in nasal symptom severity and quality of patient's life. The incidence of surgical complications and other objective outcomes were considered secondary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This review included 24 clinical studies involving 1677 patients with refractory AR, of which 510 patients in six studies had combined chronic rhinosinusitis with nasal polyps (CRSwNP) and 95 patients in one study had combined asthma. Postoperative PROMs were significantly better than preoperatively in almost all patients who underwent vidianp (RQLQ: standardized mean difference [SMD]\u00a0=\u00a02.66, 95% confidence interval [CI]\u00a0=\u00a02.40\u20132.92, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001; VAS: SMD\u00a0=\u00a05.15, 95% CI\u00a0=\u00a04.29\u20136.02, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) or vidian\u2010branch neurectomy (RQLQ in PNN: SMD\u00a0=\u00a03.29, 95% CI\u00a0=\u00a02.45\u20134.13, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001; VAS in PNN: SMD\u00a0=\u00a04.38, 95% CI\u00a0=\u00a03.41\u20135.34, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), and were generally better than in the conservative treatment group. Dividing with 18 months as the cutoff point, a subgroup analysis of the follow\u2010up period was conducted, and the results showed that both long\u2010term and short\u2010term postoperative patients had considerably reduced symptoms compared to the preoperative period. The two surgical procedures, SVN and PNN, attributed to vidian\u2010branch neurectomy have extremely few complications. However, EVN is more likely to cause dry eyes and palatal numbness, with no other serious complications. In patients with AR and CRSwNP, vidian or selective vidian neurectomy combined with functional endoscopic sinus surgery (FESS) is more effective than conventional FESS (RQLQ: SMD\u00a0=\u00a02.17, 95% CI\u00a0=\u00a01.66\u20132.69, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001; VAS: SMD\u00a0=\u00a06.42, 95% CI\u00a0=\u00a04.78\u20138.06, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). For patients who have both AR and asthma, SVN with pharyngeal branch excision is a potential treatment option.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>EVN and vidian\u2010branch neurectomy (including SVN and PNN) are effective treatments, but the former has a higher risk of complications. Additionally, vidian\u2010branch neurectomy with FESS is beneficial for patients with mixed CRSwNP. SVN is a potential approach for patients with coexisting AR and asthma.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.23259","type":"journal-article","created":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T08:58:35Z","timestamp":1694854715000},"page":"679-694","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Endoscopic vidian and vidian\u2010branch neurectomy for refractory allergic rhinitis: A systematic review"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1225-1187","authenticated-orcid":false,"given":"Xun","family":"Niu","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjun","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology  Wuhan 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