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.

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.

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.

Powered Instrumentation in Functional Endoscopic Sinus Surgery II: A Comparative Study

1996 ◽  
Vol 75 (1) ◽  
pp. 42-44 ◽  
Author(s):  
John H. Krouse ◽  
Dewey A. Christmas
Keyword(s):  
Comparative Study ◽  
Endoscopic Sinus Surgery ◽  
Middle Turbinate ◽  
Surgical Techniques ◽  
Postoperative Recovery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Surgical Results ◽  
Standard Techniques

The present paper compares the use of the microdebrider as a form of powered instrumentation for endoscopic sinus surgery with traditional endoscopic surgical techniques. A group of 250 patients undergoing surgery with the microdebrider was compared with a group of 225 patients undergoing traditional procedures in order to evaluate their postoperative recovery, healing, and incidence of complications. The use of the microdebrider demonstrated faster healing with less crusting than standard techniques, as well as decreased bleeding, synechia formation, lateralization of the middle turbinate, and ostial reocclusion. The microdebrider offers excellent surgical results with fewer complications and faster healing than traditional techniques in functional endoscopic sinus surgery.

Anatomical Variations in Osteomeatal Complex among Patients undergoing Functional Endoscopic Sinus Surgery

2016 ◽  
Vol 9 (1) ◽  
pp. 28-32 ◽  
Author(s):  
V Narendrakumar ◽  
V Subramanian
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Middle Turbinate ◽  
Preoperative Assessment ◽  
Ct Scanning ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Frequency Of Occurrence ◽  
Osteomeatal Complex

ABSTRACT Aims To study the anatomical variations of osteomeatal complex and the importance of preoperative computed tomography (CT) in patients with chronic sinusitis undergoing functional endoscopic sinus surgery. We studied the different variations and their frequency of occurrence. Materials and methods A total of 100 patients undergoing endoscopic sinus surgery were studied by nasal endoscopy, CT scanning, and at the time of definitive surgery, variations were recorded. Results The frequency of occurrence of sinonasal anatomical variations was septal deviation in 76%, agger nasi cells in 71%, concha bullosa in 61%, medialized uncinate process in 48%, prominent bulla ethmoidalis in 41%, paradoxical middle turbinate in 33%, accessory maxillary ostium in 28%, frontal cell in 22%, intumescentia septi nasi anterior in 21%, lateralized uncinate in 15%, pneumatized uncinate process in 4%, Haller cells in 12%, and Onodi cells in 8%. Conclusion The high incidence of variations emphasizes the need for proper preoperative assessment for safe and effective endoscopic sinus surgery. How to cite this article Narendrakumar V, Subramanian V. Anatomical Variations in Osteomeatal Complex among Patients undergoing Functional Endoscopic Sinus Surgery. Clin Rhinol An Int J 2016;9(1):28-32.

Nasal endoscopy in chronic maxillary sinusitis

1989 ◽  
Vol 103 (3) ◽  
pp. 275-278 ◽  
Author(s):  
R. H. Kamel
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Maxillary Sinusitis ◽  
Anatomical Variations ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Nasal Endoscopy ◽  
Middle Meatus ◽  
Egyptian Patients ◽  
Chronic Maxillary Sinusitis

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.

scholarly journals Retroverted Uncinate Process: An Anatomic Variation

2009 ◽  
Vol 24 (2) ◽  
pp. 40 ◽  
Author(s):  
Armando T. Isla ◽  
Josefino G. Hernandez
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Anatomic Variation ◽  
Middle Turbinate ◽  
Uncinate Process ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Anatomic Variations ◽  
Intelligent Decision Making ◽  
Intelligent Decision ◽  
Ct Analysis

Considerable attention has been directed toward analysis of paranasal sinus anatomy through coronal plane computerized tomographic (CT) imaging in this age of functional endoscopic sinus surgery.  Recently, it has become apparent that anatomic variations are also evident on CT analysis of patients.  Subtle anatomic features can now be imaged through CT, with a level of clarity previously not afforded by standard sinus radiographs.1         The key to a successful endoscopic sinus surgery is the proper identification of landmarks, and intelligent decision-making should there be any doubts as to what structure lies ahead.  The middle turbinate is the main landmark in the region and should be preserved if possible.  Attention to the limits of the middle turbinate landmark is one of the keys to uncomplicated surgery.2   The presence of a retroverted uncinate process, wherein the uncinate process ( rather than the middle turbinate) is the first bone to encountered, can be misleading to the rhinologic surgeon and lead to inadequate surgery.  Familiarity with anatomic variations such as the retroverted uncinate process should increase the safety and effectiveness of functional endoscopic sinus surgery.  

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