Modified Endoscopic Medial Maxillectomy for Chronic Maxillary Sinusitis

2006 ◽  
Vol 20 (3) ◽  
pp. 317-319 ◽  
Author(s):  
Bradford A. Woodworth ◽  
Ryan O. Parker ◽  
Rodney J. Schlosser
Keyword(s):  
Inflammatory Disease ◽  
Maxillary Sinusitis ◽  
Demographic Data ◽  
Nasolacrimal Duct ◽  
Sinus Surgery ◽  
Alternative Technique ◽  
Middle Meatal Antrostomy ◽  
Medial Maxillectomy ◽  
Chronic Maxillary Sinusitis

Background Recently, modified endoscopic medial maxillectomy (MEMM) has been described as an alternative technique to open maxillectomy for benign sinonasal neoplasms. However, few reports discuss the efficacy of MEMM for treatment of inflammatory disease of the maxillary sinus. We evaluate the efficacy of MEMM in treating chronic maxillary sinusitis. Methods A retrospective review of patients who underwent MEMM for refractory inflammatory disease between December 2002 and September 2004 was performed. All patients were treated with MEMM alone or as part of an endoscopic sinus surgery procedure. Standard demographic data, operative technique, and postoperative follow-up times were collected. Results Nineteen patients (average age, 57 years) underwent 24 EMMs for chronic maxillary sinusitis refractory to middle meatal antrostomy. All patients failed prior sinus surgery, including 14 Caldwell-Luc procedures. Average follow-up was 19.5 months (range, 10–27 months). One patient has persistent hyperplastic sinusitis that currently requires monthly follow-up and medical treatment. Our only complication was one nasolacrimal duct injury. Conclusion MEMM is both a safe and an effective treatment for chronic maxillary sinusitis refractory to standard medical and endoscopic surgical management.

Endoscopic transnasal surgery in chronic maxillary sinusitis

1989 ◽  
Vol 103 (5) ◽  
pp. 492-501 ◽  
Author(s):  
R. H. Kamel
Keyword(s):  
Maxillary Sinusitis ◽  
Anatomical Variations ◽  
Safe Procedure ◽  
Subjective Improvement ◽  
Healthy Mucosa ◽  
Middle Meatal Antrostomy ◽  
Transnasal Surgery ◽  
Chronic Maxillary Sinusitis ◽  
Maxillary Sinuses

AbstractThe treatment of chronic maxillary sinusitis aims at the re-establishment of proper aeration and drainage of the antrum. Middle meatal antrostomy offers ventilation and clearance of the antrum and has anatomical, physiological, physical and pathological basis.This work included 66 cases of chronic maxillary sinusitis, for whom 94 operations of endoscopic middle meatal antrostomy were performed (38 unilateral and 28 bilateral procedures). Any associated anatomical variations and/or pathological abnormalities at the ostiomeatal area were dealt with. Follow-up of these cases for periods ranging from four to 12 months showed that 95.5 per cent of the cases experienced subjective improvement. Endoscopically 96.8 per cent of the antrostomies were patent and 94.7 per cent of the maxillary sinuses were clear and regained healthy mucosa. The author concluded that middle meatal antrostomy, when done endoscopically, is a safe procedure with good results

Transformation of Mucosal Secretory Elements in Chronic Maxillary Sinusitis after Endoscopic Sinus Surgery

1994 ◽  
Vol 103 (6) ◽  
pp. 439-443 ◽  
Author(s):  
Sheen- Yie Fang
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Maxillary Sinusitis ◽  
Goblet Cells ◽  
Sinus Surgery ◽  
Antral Mucosa ◽  
Rear Wall ◽  
Chronic Maxillary Sinusitis ◽  
Sinus Mucosa ◽  
Scanning Electron

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.

Endoscopic and Caldwell-Luc Approach in Chronic Maxillary Sinusitis: Intraoperative and Early Postoperative Results

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
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Maxillary Sinusitis ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Surgical Approaches ◽  
Postoperative Results ◽  
Intraoperative Bleeding ◽  
Facial Swelling ◽  
Middle Meatal Antrostomy ◽  
Chronic Maxillary Sinusitis

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).

Endoscopic Findings after Functional and Radical Sinus Surgery: A Prospective Randomized Study

1994 ◽  
Vol 8 (2) ◽  
pp. 71-76 ◽  
Author(s):  
Matti A. Penttilä
Keyword(s):  
Maxillary Sinusitis ◽  
Randomized Study ◽  
Endoscopic Examination ◽  
Sinus Surgery ◽  
Surgical Approaches ◽  
Subjective Symptoms ◽  
Endoscopic Findings ◽  
Mucosal Thickness ◽  
Chronic Maxillary Sinusitis

Functional endoscopic (FES) and radical Caldwell-Luc (C-L) surgical approaches were compared in a prospective randomized trial of 150 consecutive patients (aged 14–88 years) suffering from chronic maxillary sinusitis over 3 months’ duration refractory to medical and repeated antral irrigation therapy. A total of 143 patients with 109 operated antra in the C-L group and 127 antra in the FES group were available for the follow-up nasal and antral endoscopic examination median 12 months postoperatively. Both modalities proved effective in relieving subjective symptoms. Postoperatively, FES antra contained markedly fewer secretions, although the endoscopically enlarged natural antral ostium was closed in 18.6% of the sinuses. The inferior meatal antrostomies of the C-L operation were markedly stenosed or closed in 31.4% of the sinuses. Antral mucosal thickness and antral polyps diminished significantly after both operations, but large polyps were found more often after FES.

Maxillary Sinus Atelectasis with Enophthalmos

1998 ◽  
Vol 107 (1) ◽  
pp. 34-39 ◽  
Author(s):  
James H. Boyd ◽  
Karen Yaffee ◽  
John Holds
Keyword(s):  
Bone Resorption ◽  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Endoscopic Technique ◽  
Orbital Floor ◽  
Review Of The Literature ◽  
Comprehensive Review ◽  
Middle Meatal Antrostomy ◽  
Chronic Maxillary Sinusitis ◽  
Sinus Ostium

Chronic maxillary sinusitis may present as atelectasis of the sinus with changes to surrounding structures. Several mechanisms have been proposed for this problem. Chronic obstruction of the sinus ostium, with resultant retention of secretions and osteitic bone resorption, may account for these changes. Enophthalmos is one manifestation that may require corrective treatment. Titanium micromesh reconstruction of the orbital floor, with or without onlay concha cartilage, has reliably resolved the enophthalmos. Reconstruction of the orbital floor and ventilation of the obstructed sinus ostium may be carried out relatively safely in a single operation. The standard endoscopic technique of uncinate removal and middle meatal antrostomy should be modified to prevent orbital penetration. This report reviews our series of 6 patients with this problem, as well as a comprehensive review of the literature. Recommendations for management of both the obstruction and the secondary orbital manifestations are presented.

scholarly journals Treatment of Recalcitrant Maxillary Sinusitis With Endoscopic Modified Medial Maxillectomy: A Systematic Review of Safety and Efficacy

2019 ◽  
Vol 34 (1) ◽  
pp. 127-133 ◽  
Author(s):  
Catherine A. Loftus ◽  
Frederick Yoo ◽  
Vincent M. Desiato ◽  
Rodney J. Schlosser ◽  
Zachary M. Soler
Keyword(s):  
Systematic Review ◽  
Maxillary Sinusitis ◽  
Sinus Surgery ◽  
Quality Level ◽  
Effective Treatment Option ◽  
Safety And Efficacy ◽  
Symptom Resolution ◽  
Medial Maxillectomy ◽  
Level 2 ◽  
Modified Medial Maxillectomy

Background Endoscopic sinus surgery is an effective treatment option for patients with chronic rhinosinusitis (CRS), although approximately 20% of patients fail to improve with standard surgical procedures. Expanded procedures such as the endoscopic modified medial maxillectomy (EMMM) have been described in management of refractory maxillary sinusitis. Objective This study aims to review the current literature on the safety and efficacy of the EMMM for treatment of refractory maxillary sinusitis. Methods A literature search was performed of PubMed, Ovid, and Cochrane databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. English-language articles evaluating the EMMM procedure on patients with recalcitrant maxillary sinusitis were included. Full-text articles were obtained and evaluated by 2 reviewers independently, with a third reviewer for mediation of disagreements. Results Six studies met eligibility criteria and were included into the study, with follow-up ranging from 12 to 82.8 months. Two studies contained Level 2 evidence and 4 studies contained Level 4 evidence. EMMM was found to be effective in CRS and cystic fibrosis-related CRS (0% and 9.1% revision rate, respectively). Symptom resolution was noted 60% to 80% of patients. Four studies reported complications, with a total of 4 complications out of 211 patients. Conclusions There are no high-quality Level 1 studies evaluating the efficacy and safety of the EMMM procedure. Level 2 to Level 4 studies indicate that this procedure is relatively safe with a low complication rate and symptom resolution in up to 80% of patients with recalcitrant maxillary sinusitis.

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 FESS in the Management of Chronic Maxillary Sinusitis

2010 ◽  
Vol 14 (Number 1) ◽  
pp. 9-12
Author(s):  
N U Khan ◽  
Md. Daulatuzzaman ◽  
Md. A Sikder ◽  
H Rashid ◽  
S M K A Mazumder
Keyword(s):  
Minimally Invasive ◽  
Maxillary Sinusitis ◽  
Disease Process ◽  
Invasive Procedure ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Minimally Invasive Procedure ◽  
College Hospital ◽  
Medical College ◽  
Chronic Maxillary Sinusitis

Functional endoscopic sinus surgery (FESS) is the minimally invasive procedure to clear the disease process from nose and pansnasal sinuses like chronic maxillary sinusitis and to restore aeration and normal nutcocilliary function of sinuses. FESS has recently become a popular technique among the otolatyngologists of Bangladesh. The use of endoscope during FESS improves visualization, enables greater preservation of normal structures and reduces the necessity for wide exposure of operation fields. The result suggests that FESS is a safe and effective method in the treatment of chronic maxillary sinusitis. This study of 50 cases was done front January 2007 to December 2007 at Holy Family Red Crescent Medical College Hospital where FESS is routinely done for the management of chronic maxillary sinusitis. In this study, 76% (38) were completely free from symptom, 16% (08) improved, 4% (02) encountered recurrence of symptom and persistence of symptom observed in another 4% (02) cases. Most of the patients (62%) in this series of FESS were operated without facing any difficulties. Majority of the patients (94%) were released from the hospital within two days of FESS. No post-operative complication was found in 62% patients. FESS for inflammatory sinus diseases is now well established but one should be cautious about the complications associated with Otis technique.

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