Drug delivery in the nasal cavity after functional endoscopic sinus surgery: a computational fluid dynamics study

2012 ◽  
Vol 126 (5) ◽  
pp. 487-494 ◽  
Author(s):  
X B Chen ◽  
H P Lee ◽  
V F H Chong ◽  
D Y Wang
Keyword(s):  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Particle Deposition ◽  
Particle Diameter ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Airflow Rate ◽  
Sinus Cavity ◽  
The Right

AbstractBackground:Intranasal medication is commonly used for nasal disease. However, there are no clear specifications for intranasal medication delivery after functional endoscopic sinus surgery.Methods:A three-dimensional model of the nasal cavity was constructed from computed tomography scans of an adult Chinese male who had previously undergone functional endoscopic sinus surgery in the right nasal cavity. Computational fluid dynamic simulations modelled airflow and particle deposition, based on discrete phase models.Results:In the right nasal cavity, more particles passed through the upper dorsal region, around the surgical area, and streamed into the right maxillary sinus region. In the left cavity, particles were distributed more regularly and uniformly in the ventral region around the inferior turbinate. A lower inspiratory airflow rate and smaller initial particle velocity assisted particle deposition within the right maxillary sinus cavity. In the right nasal cavity, the optimal particle diameter was approximately 10−5 m for maxillary sinus cavity deposition and 3 × 10−6 m for bottom region deposition. In the right nasal cavity, altered back head tilt angles enhanced particle deposition in the top region of the surgical area, and altered right side head tilt angles helped enhance maxillary sinus cavity deposition.Conclusion:This model indicates that a moderate inspiratory airflow rate and a particle diameter of approximately 10−5 m should improve intranasal medication deposition into the maxillary sinus cavity following functional endoscopic sinus surgery.

Aerodynamic Characteristics inside the Rhino-Sinonasal Cavity after Functional Endoscopic Sinus Surgery

2011 ◽  
Vol 25 (6) ◽  
pp. 388-392 ◽  
Author(s):  
Xiao Bing Chen ◽  
Heow Pueh Lee ◽  
Vincent Fook Hin Chong ◽  
De Yun Wang
Keyword(s):  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Airflow Rate ◽  
Nasal Airflow ◽  
Cfd Simulations ◽  
Inertia Effects ◽  
The Right

Background The aim of this study was to evaluate effects of functional endoscopic sinus surgery (FESS) on transient nasal aerodynamic flow patterns using computational fluid dynamics (CFD) simulations. Methods A three-dimensional model of the nasal cavity was constructed from CT scans of a patient with FESS interventions on the right side of the nasal cavity. CFD simulations were then performed for unsteady aerodynamic flow modeling inside the nasal cavity as well as the sinuses. Results Comparisons of the local velocity magnitude and streamline distributions inside the left and right nasal cavity and maxillary sinus regions were presented. Because of the FESS procedures in the right nasal cavity, existences and distributions of local circulations (vortexes) were found to be significantly different for the same nasal airflow rate but at different acceleration, deceleration, or quiet phases in the maxillary sinus region on the FESS side. Because of inertia effects, local internal airflow with circulation existences was continuous throughout the whole respiration cycle. With a larger peak inspiration flow rate, the airflow intensity inside the enlarged maxillary sinus increased significantly. Possible outcomes on functional performances of the nose were also examined and discussed. Conclusion Surgical enlargements of natural ostium of the maxillary sinus will change the aerodynamic patterns inside the main nasal cavity and maxillary sinus regions, which may affect normal nasal physiological functions. Local inertia effects play more important roles for the internal nasal airflow pattern changes and thus such conventional FESS procedures should be carefully planned.

scholarly journals "Silent sinus syndrome": One more indication for functional endoscopic sinus surgery

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 65-68
Author(s):  
Ljiljana Jovancevic ◽  
Slobodan Savovic ◽  
Slavica Sotirovic-Senicar ◽  
Maja Buljcik-Cupic
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Rare Condition ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Orbital Floor ◽  
Orbital Trauma ◽  
Silent Sinus Syndrome ◽  
Slow Development ◽  
The Right

Introduction. Silent sinus syndrome is a rare condition, characterized by spontaneous and progressive enophthalmos and hypoglobus associated with atelectasis of the maxillary sinus and downward displacement of the orbital floor. Patients with this syndrome present with ophthalmological complaints, without any nasal or sinus symptoms. Silent sinus syndrome has a painless course and slow development. It seems to be a consequence of maxillary sinus hypoventilation due to obstruction of the ostiomeatal unit. The CT scan findings are typical and definitely confirm the diagnosis of silent sinus syndrome. Case report. We present the case of a 35-year-old woman, with no history of orbital trauma or surgery. She had slight righthemifacial pressure with no sinonasal symptoms. The patient had no double vision nor other ophthalmological symptoms. The diagnosis of silent sinus syndrome was based on the gradual onset of enophthalmos and hypoglobus, in the absence of orbital trauma (including surgery) or prior symptoms of sinus disease. On paranasal CT scans there was a complete opacification and atelectasis of the right maxillary sinus with downward bowing of the orbital floor. The patient was treated with functional endoscopic sinus surgery, with no orbital repair. Conclusion. Silent sinus syndrome presents with orbithopaties but is in fact a rhinologic disease, so all ophthalmologists, rhinologists and radiologists should know about it. The treatment of choice for silent sinus syndrome is functional endoscopic sinus surgery, which should be performed with extra care, by an experienced rhinosurgeon.

The early history and development of functional endoscopic sinus surgery

2019 ◽  
Vol 134 (1) ◽  
pp. 8-13
Author(s):  
K J Kane
Keyword(s):  
Twentieth Century ◽  
Nasal Cavity ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Early History ◽  
Sinus Surgery ◽  
Diagnosis And Management ◽  
The World ◽  
English Speaking

AbstractBackgroundThe concept of endoscopic diagnosis and procedures on the nasal cavity had been investigated for several decades in Europe in the early part of the twentieth century. It was Prof Walter Messerklinger and his assistant, Heinz Stammberger, with US colleague, David Kennedy, who brought the science and technique of functional endoscopic sinus surgery to the wider world.MethodsThe author, an English-speaking surgeon, was present at this movement from the commencement of its propagation, and has recorded the remarkable ascendency of this technique throughout the world.ConclusionThe technique revolutionised the diagnosis and management of intranasal, sinus and intracranial conditions.

Effect of Functional Endoscopic Sinus Surgery on the Maxillary Sinus Mucosa

2004 ◽  
Vol 131 (2) ◽  
pp. P269-P269
Author(s):  
Wilma T Anselmo Lima ◽  
Fabiana Cardoso Pereira Valera ◽  
Ricardo Cassiano Demarco ◽  
Valder Rodrigues de Mello
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Sinus Mucosa

Ultrastructural ciliary changes of maxillary sinus mucosa following functional endoscopic sinus surgery: an image analysis quantitative study

2003 ◽  
Vol 117 (4) ◽  
pp. 273-279 ◽  
Author(s):  
Ahmed Bassiouny ◽  
Ahmed M. Atef ◽  
Mahmoud Abdel Raouf ◽  
Safaa Mohamed Nasr ◽  
Magdy Nasr ◽  
...  
Keyword(s):  
Image Analysis ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Quantitative Methods ◽  
Maxillary Sinusitis ◽  
Functional Endoscopic Sinus Surgery ◽  
University Hospital ◽  
Sinus Surgery ◽  
Chronic Maxillary Sinusitis ◽  
Sinus Mucosa

This was a study of the effect of functional endoscopic sinus surgery (FESS) on the ciliary regeneration of maxillary sinus mucosa in patients with chronic maxillary sinusitis, using objective quantitative methods. Twenty specimens from the mucosa of both the superolateral wall and the ostium of the maxillary sinus were sampled during FESS and then six to 12 months later. They were light examined first by light microscopy and then by scanning electron microscopy in combination with image analysis software in order to study the cilia under higher magnification and to calculate proportion of the field that was ciliated. Samples were taken and studied at Cairo University hospital. This study showed that the maxillary sinus mucosa in chronic sinusitis is capable of regeneration and could return towards normal with the improvement of ventilation and drainage of the maxillary sinus following FESS. There were no significant changes in the degree of glandular hyperplasia, goblet cells or pathological glands after surgery.

scholarly journals Evaluation of Anatomical Variations in Maxillary Sinus and Management of Chronic Sinonasal Disease

2021 ◽  
Vol 10 (38) ◽  
pp. 3351-3355
Author(s):  
Ganesh Manohar Vihapure ◽  
Akshay Sorade ◽  
Kaenat Ahmed ◽  
Lakshmi Sravya Yarlagadda ◽  
Khaleel Basha Munnaru
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Anatomical Variations ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Successful Outcome ◽  
Operative Care ◽  
Number Of Patients

BACKGROUND The paranasal sinuses (PNS) have various anatomical difference. Computed tomography (CT) is an excellent means of providing anatomical information of this region, disease extent, assisting endoscopic evaluation and guiding treatment. Functional endoscopic sinus surgery (FESS) has become an increasingly popular treatment for chronic sinus diseases. CT of the paranasal sinuses has become a roadmap for FESS. The present study focuses on the assessment of the efficacy, safety and benefits of functional endoscopic sinus surgery in cases of maxillary pathologies and also study the anatomical variations in maxillary sinus in computed tomography and its usefulness in planning and management of chronic sinonasal diseases. METHODS It was a prospective study and a total of 80 patients were included in this study from July 2019 to June 2020 in the Otolaryngology Department, KIMS, Karad. Standard surgical steps were applied in each case according to the extent of disease. All patients underwent standard post-operative care. All findings were recorded and studied. RESULTS Total number of patients were 80. Of which, 31 (38.75 %) patients were operated for ethmoidal polyp, 24 (30 %) for chronic rhinosinusitis, 10 (12.5 %) for antrochoanal polyp, 9 (11.25 %) for rhinosporidiosis and 6 (7.5 %) for inverted papilloma. Postoperative complications were periorbital echymoses (13 %), synechiae (2.5 %), epiphora (2.5 %), infection (2.5 %), hemorrhage (4 %). Complete relief of symptoms were noted in 81.67 % cases. CONCLUSIONS Successful outcome and patient satisfaction post treatment can be obtained by careful evaluation and patient selection by history, examination and most importantly, proper imaging of the sinuses. KEY WORDS Maxillary Sinus, Sinusitis, Nasal Polyp, Paranasal Sinus Disease, Computed Tomography (CT)

Computed tomography assessment of the ethmoid roof based on Keros classification in Iraqi patients undergoing functional endoscopic sinus surgery

2021 ◽  
Vol 4 (2) ◽  
pp. 365-370
Author(s):  
Baseem Natheer Abdulhadi ◽  
Ali Ibrahim Shyaa ◽  
Laith ALTamimi
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Cross Sectional Study ◽  
Common Type ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
P Value ◽  
Type I ◽  
Cross Sectional ◽  
And Gender ◽  
The Right

Background: Among the most popular methods employed to classify the depth of the olfactory fossa is Keros classification. This study aims to assess Keros classification of the ethmoid roof, any possible association between Keros types and gender, and the incidence of asymmetry between right and left sides among Iraqi patients.  Methods: A retrospective cross-sectional study was conducted at Al-Shaheed Gazi Al-Hariri Teaching Hospital, Medical City, Baghdad, Iraq. The archived reports and the CT scans images (nose and paranasal sinuses) of 126 patients who have undergone functional endoscopic sinus surgery between January 2019 and January 2020 were reviewed. Univariate and bivariate statistical analysis was performed using SPSS version 24. The statistically significant was considered at less than 0.05. Results: More than half of patients were females (54.0%) with a mean age of 31.52 ± 11.38 (SD) years (range: 10-57 years). Among the total patients, the mean depth of olfactory fossa (OF) was 3.58 ± 0.02 mm. Results showed that Keros type I was the most common type (71.0%), followed by type II (27.4%) and type III (1.6%) respectively. The difference in the olfactory fossa depth between the right and left sides was ≥ 1 mm in 16 (12.7%) patients and < 1 mm in 110 (87.3%) patients. Moreover, there was no significant relation between symmetry/asymmetry and gender ( p-value > 0.05). Conclusion: Keros type I was the most common type, which carries the lowest risk of inadvertent intracranial injury during endoscopic sinus surgery; besides the relatively low percentage of asymmetry in the depth of the two olfactory fossae among patients, surgeons should always be cautious during surgery to avoid iatrogenic injury concerning the thin lateral lamella of the cribriform plate.

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