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 ◽  
...  

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.

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

1989 ◽  
Vol 103 (3) ◽  
pp. 275-278 ◽  
Author(s):  
R. H. Kamel

AbstractThe role of the anterior ethmoids in the pathogenesis of chronic maxillary sinusitis is still a subject of controversy. Although the symptoms of maxillary sinusitis may be clinically dominant, many previous studies have showed that the origin of this disease was, in most cases, located within the anterior ethmoid region.This study included 100 Egyptian patients, suffering from chronic maxillary sinusitis (confirmed by maxillary sinoscopy), who were subjected to ‘systematic nasal endoscopy’. It was found that all cases of chronic maxillary sinusitis were associated with anatomical variations and/or pathological abnormalities of ‘the ostiomeatal area’. It is recommended, therefore, that during the diagnosis and treatment of chronic maxillary sinusitis, attention should be given to the region of the middle meatus and anterior ethmoid complex (or ‘ostiomeatal area’) for any anatomical variations and/or pathological abnormalities in order to avoid recurrence of maxillary sinusitis. This is the basis of the procedure of functional endoscopic sinus surgery.


2007 ◽  
Vol 21 (6) ◽  
pp. 719-724 ◽  
Author(s):  
Wilma T. Anselmo-Lima ◽  
Maria Dolores Seabra Ferreira ◽  
Fabiana Cardoso Pereira Valera ◽  
Maria Rossato ◽  
Valder Rodrigues de Mello ◽  
...  

1994 ◽  
Vol 103 (6) ◽  
pp. 439-443 ◽  
Author(s):  
Sheen- Yie Fang

To evaluate the secretory element transformation of maxillary sinus mucosa after endoscopic sinus surgery (ESS), I enrolled 20 patients. Five normal antral mucosae were used as controls, and 15 antral mucosae were investigated according to pathologic and secretory patterns. The post-ESS mucosa was evaluated at the 16th week, when gross recovery appeared. Specimens from the rear wall of the antrum were observed under a scanning electron microscope (x2,000). A significant decrease of goblet cells and increase of glands was illustrated in the sinusitis cases, especially the polypoid and purulent groups. In post-ESS cases, the number of goblet cells is about the same as in controls, but the number of gland openings is higher. My conclusions were that 1) the repair of the antral mucosa requires more time than gross recovery and 2) post-ESS follow-up should be longer than 16 weeks to prevent recurrence.


1993 ◽  
Vol 7 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Matti A. Penttilä ◽  
Markus E.P. Rautiainen ◽  
Jussi E. Laranne ◽  
Juhani S. Pukander ◽  
Pekka H. Karma

Endoscopic and Caldwell-Luc surgical approaches in 150 consecutive patients (aged 14–88 years) suffering from chronic maxillary sinusitis were compared. The patients were randomly subjected either to functional endoscopic sinus surgery (FES) with middle meatal antrostomy (n = 75) or to the Caldwell-Luc (C-L) operation (n = 75). In the FES group intraoperative bleeding was significantly lower than in the C-L group. There were no major complications during or after surgery in either group. Moderate or marked postoperative facial swelling and fever were more common in the C-L patients and also the need of analgetics was more frequent among them. One month postoperatively the antral irrigation findings did not differ between the groups, but C-L operated patients expressed more frequently distinct complaints than FES patients (P < .001).


1997 ◽  
Vol 106 (9) ◽  
pp. 759-766 ◽  
Author(s):  
Bert Hartog ◽  
Ludo C. Prins ◽  
Peter-Paul G. van Benthem ◽  
Gert-Jan Hordijk

Sinus irrigation is the traditional treatment for chronic maxillary sinusitis. Functional endoscopic sinus surgery (FESS) restores aeration and allows secretions to be removed from an infected sinus. This study compares the efficacy of sinus irrigation with that of sinus irrigation followed by FESS in 89 patients. We measured the effects by way of sinus radiographs, nasendoscopic findings, and patient complaints. When we analyzed the data in terms of intent to treat, we found significantly favorable results for sinus irrigation followed by FESS at the end point, though only for loss of smell and purulent rhinitis. Treatment consisting of sinus irrigation alone prevented surgery in 58% of all patients for 1 year. Both treatment methods were combined with a 10-day course of loracarbef, which might have contributed to the outcome. We conclude that a good option for treatment of chronic maxillary sinusitis seems to be sinus irrigation in combination with a broad-spectrum antibiotic followed by FESS.


2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 65-68
Author(s):  
Ljiljana Jovancevic ◽  
Slobodan Savovic ◽  
Slavica Sotirovic-Senicar ◽  
Maja Buljcik-Cupic

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.


1989 ◽  
Vol 98 (11) ◽  
pp. 901-906 ◽  
Author(s):  
David W. Kennedy ◽  
Hisham Shaalan

Functional endoscopic sinus surgery concentrates primarily on the removal of ostiomeatal complex disease. When required, maxillary sinus ostioplasty is performed. However, surgical widening of a sinus ostium is contrary to common precepts. A study therefore was performed to reevaluate the effects of antrostomies and of intrasinus mucosal removal. Widening of the natural ostium, a separate antrostomy at some distance from the ostium, or radical mucosal removal was performed on 30 rabbits. Fifteen sinuses were used as controls. After 6 to 8 weeks the status of the sinus mucosa and mucociliary clearance was studied. The study confirmed that mucociliary clearance continued toward the natural ostium following inferior antrostomy. Following widening of the natural ostium, mucociliary clearance through the ostium redeveloped in 11 of 18 sinuses but was typically imperfect. There were no cases of ostial closure; however, the incidence of infection was significantly higher in all three experimental groups than in the control group.


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