Remodeling of the Paradoxical Middle Turbinate: Preserving Function While Gaining Access

2018 ◽  
Vol 32 (2) ◽  
pp. 98-100
Author(s):  
Ryan H. Belcher ◽  
Allison K. Ikeda ◽  
John M. DelGaudio
Keyword(s):  
Medical Treatment ◽  
Chronic Rhinosinusitis ◽  
Surgical Approach ◽  
Endoscopic Sinus Surgery ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Middle Meatus ◽  
Anatomic Variant ◽  
And Function ◽  
Improve Access

Background Endoscopic sinus surgery is performed for many reasons, most commonly for chronic rhinosinusitis refractory to medical treatment. A paradoxical middle turbinate is an anatomic variant that can hinder endoscopic access to the sinuses. No publication has addressed how to surgically treat a paradoxical middle turbinate. Method We present a basic endoscopic surgical approach to conservatively resect a paradoxical middle turbinate in order to improve access to the middle meatus and the sinuses while preserving support and function. Conclusion Conservative remodeling of the paradoxical middle turbinate can provide access to the sinuses while maintaining a significant portion of the middle turbinate.

Two different therapies for the middle turbinate during endoscopic sinus surgery for chronic rhinosinusitis

2020 ◽  
Vol 277 (11) ◽  
pp. 3079-3089
Author(s):  
Meichan Zhu ◽  
Yongyi Yan ◽  
Huicheng Gong ◽  
Yunwen Wu ◽  
Guojie Tan
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Middle Turbinate ◽  
Sinus Surgery

scholarly journals A safe way to find the posterior ethmoidal cells: navigation with cottonoid

2016 ◽  
Vol 6 (21) ◽  
pp. 41-43
Author(s):  
Carlos Miguel Chiesa Estomba ◽  
Frank Alberto Betances Reinoso ◽  
Carmelo Santidrian Hidalgo
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Middle Turbinate ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Middle Meatus ◽  
Anatomical Variant ◽  
Superior Meatus ◽  
In The Beginning ◽  
Difficult Cases ◽  
Complex Cases

Abstract BACKGROUND. Functional endoscopic sinus surgery (FESS) is a reliable option in the treatment of sinus pathology, but the presence of the anatomical variant and difficult cases like massive polyposis or revision FESS can generate some problems to surgeons. MATERIAL AND METHODS. After performing an unciformectomy, a partial anterior ethmoidectomy and maxillary ostium antrostomy, we slide a cottonoid back to the basal lamella of the middle turbinate with a Cottle dissector and introduce it in the superior meatus. After that, we return to the middle meatus and proceed to open the basal lamella finding the cottonoid placed there previously. RESULTS. An easy technique, safe and reproducible, that allows us to advance in our dissection, avoiding damaging important structures. CONCLUSION. In this paper we present a safe way to approach the posterior ethmoidal cells complex in the classic way through the basal lamella of the middle turbinate, under the guidance of a cottonoid, a safe and easy maneuver to do this procedure in the beginning of our formation or in complex cases.

Concha bullosa mucocele - endoscopic surgical solution

ORL ro ◽  
2016 ◽  
Vol 4 (1) ◽  
pp. 60-62
Author(s):  
Andreea Nicoleta Costache ◽  
C. Ioniţă ◽  
Alexandra Guligă ◽  
A. Panfiloiu ◽  
Tatiana  Decuseară ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
Sinus Surgery ◽  
Middle Meatus ◽  
Concha Bullosa ◽  
Appropriate Treatment

Headache is a borderline pathology, faced by physicians of various specialties, which has to be thoroughly investigated to establish the etiology and appropriate treatment. The authors present a case of concha bullosa mucocele managed by endoscopic sinus surgery. The mucocele was responsible for persistent nonsystemized headache and also for the chronic rhinosinusitis of the maxillary, ethmoidal and frontal sinus because of the blockage of the middle meatus. The drainage of the anterior sinuses and the mucocele of the concha bullosa were successfully managed by endoscopic sinus surgery.   

scholarly journals Anatomy of Nasal Cavity and Paranasal Sinuses; Surgical Perspective

2020 ◽  
Vol 63 (5) ◽  
pp. 189-198
Author(s):  
Seung-Kyu Chung
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Nasal Cavity ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Treatment Method ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery

Endoscopic sinus surgery is a treatment method for chronic rhinosinusitis not controlled with medical treatment. It had started with functional endoscopic sinus surgery and the concept of reboot approach was introduced recently. For safe surgical treatment, understanding the anatomy especially personal variations between well-known structures is important. The practical points of surgical concept during endoscopic sinus surgery was suggested.

scholarly journals A comparative study and correlation between preoperative computed tomogram and endoscopic sinus surgery in chronic rhinosinusitis

2019 ◽  
Vol 5 (6) ◽  
pp. 1652
Author(s):  
Mithra Sara John ◽  
N. Gopinathan Pillai
Keyword(s):  
Ct Scan ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Scoring System ◽  
Pearson Correlation ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Common Disease ◽  
Nasal Discharge ◽  
Excellent Correlation

<p class="abstract"><strong>Background:</strong> Chronic rhinosinusitis (CRS) with its classical symptoms of nasal obstruction, nasal discharge, and headache is relatively a common disease in otorhinolaryngology practice. The objectives of the present study was to correlate the operative findings in such patients with the CT findings, using the Perioperative sinus endoscopy (POSE) scoring system and to correlate the maximum scores obtained in the POSE scoring system and Lund-Mackay scoring system.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted from January 2014 to March 2015 in 50 patients suffering from chronic rhinosinusitis who underwent endoscopic sinus surgery in the age group of 36-60 years of age.  </p><p class="abstract"><strong>Results:</strong> Agger nasi cells were the most common wandering ethmoid cell detected (90%) followed by various types of frontal cells (54%), Haller cells (26%) and least commonly Onodi cells (12%). Almost perfect agreement was obtained for rest of the criteria which included middle turbinate status, ethmoid cavity mucosal edema and ethmoid cavity polypoid change. Lund-Mackay scoring system was used to score findings in the CT scan and POSE scoring system used to score peroperative findings in the study and this study reveals excellent correlation (Pearson correlation value of 0.879).</p><p><strong>Conclusions:</strong> Novel POSE scoring is a new entity which has the potential to be a valid system to score preoperative and perioperative findings. In the current study POSE scoring shows excellent correlation with Lund Mackay scoring which is an established scoring system used in the evaluation CT scan.</p>

Polyurethane Versus Chitosan-Based Polymers Nasal Packs After Functional Endoscopic Sinus Surgery: A Prospective Randomized Double-Blinded Study

2021 ◽  
pp. 194589242098364
Author(s):  
Ahmed Gamal Khafagy ◽  
Ahmed Mahmoud Maarouf
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Middle Turbinate ◽  
Mucosal Healing ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Middle Meatus ◽  
Packing Materials ◽  
Nasal Pack ◽  
Significant Difference ◽  
Double Blinded

Background Different packing materials are applied to the nose at the end of surgery to maintain drainage and sinus ventilation of the paranasal sinuses and avoid some complications such as bleeding, infection, crustations, adhesions in the middle meatus and lateralization of the middle turbinate. Objective The study aims to compare the clinical outcomes of two absorbable packing materials, the synthetic polyurethane, and the naturally occurring Chitosan-based polymers (CBP) nasal packs, after functional endoscopic sinus surgery. Methods Fifty patients with bilateral chronic rhinosinusitis with nasal polypi were operated with 100 surgical cavities. At the end of the surgery, one side was randomly packed with synthetic polyurethane and the opposite side with CBP nasal pack. Measure their outcomes at week 1, 2, 4, 8 and 12 as the presence of remnants materials in the middle meatus, crustations, adhesions, bleeding, granulations, infection, and general satisfaction of patients. Results CBP nasal pack shows a statistically significant advantage only in the first two weeks as regard remnants material, crusting and bleeding. All over the 12 weeks, there was no statistically significant difference between the two types of packs as regard granulations, adhesions and infection. In the first month, eight patients of the CBP group experienced bad smell and two patients had watery rhinorrhea as adverse reaction without a statistically significant difference. Patients were generally satisfied without a statistically significant difference between the two types of packs. Conclusion Synthetic polyurethane and Chitosan-based polymers nasal packs are safe and efficient regarding; the mucosal healing, bleeding control, and the overall satisfaction of patients. The CBP showed a higher statistically significant advantage in the first two weeks only regarding the amount of the retained material, crusting as well as bleeding. Patients packed with CBP experienced fish-like smelly odor and watery rhinorrhea but there is no statistically significant difference.

Effectiveness of extensive sinus surgery with post-operative medical management for chronic rhinosinusitis

2017 ◽  
Vol 131 (S2) ◽  
pp. S19-S24 ◽  
Author(s):  
A J Wood ◽  
L Zhou ◽  
S Wilkinson ◽  
R G Douglas
Keyword(s):  
Confidence Interval ◽  
Medical Treatment ◽  
Chronic Rhinosinusitis ◽  
Symptom Score ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Symptom Improvement ◽  
Patient Subgroups

AbstractObjective:To prospectively assess treatment outcomes of chronic rhinosinusitis patients undergoing functional endoscopic sinus surgery and post-operative medical treatment over a prolonged follow-up period.Methods:Patients undergoing functional endoscopic sinus surgery in the tertiary referral practice of a single surgeon were studied prospectively. Symptoms were scored by patients pre-operatively and over a minimum follow-up period of 12 months.Results:The study comprised 200 non-consecutive patients. The median pre-operative symptom score was 16 (out of a maximum of 25) (95 per cent confidence interval = 15 to 17). Symptom scores reduced to a median of 7 (95 per cent confidence interval = 6 to 8) after 12 months of follow up (p< 0.0001). The median symptom score improved for all symptoms and across all patient subgroups.Conclusion:Extensive functional endoscopic sinus surgery offers significant and durable symptom improvement in patients with chronic rhinosinusitis refractory to medical treatment. This improvement extends to all patient subgroups. Prolonged medical therapy is recommended after functional endoscopic sinus surgery.

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