SURGICAL TREATMENT OF PATIENTS WITH CHRONIC RHINOSINUSITIS AND NASAL POLYPS UNDER ELECTIVE DENTAL IMPLANTAT PLACEMENT WITH SINUS LIFTING SURGERY
Dental implant placement is widely used method of dentition restoration, and if necessary, is performed with subantral augmentation of bone tissue and can be associated with an increased risk of complications in cases of mucosa alterations. To the disease and patency of the ostiomeatal complex and to minimize the possible risks is the key task when preparing patients with chronic rhinosinusitis and nasal polyps for sinus lifting. The aim of the study is to investigate the effect of shaver polipectomy method in chronic rhinosinusitis and nasal polyps on the outcomes of sinus lifting and the frequency rate of complications. Materials and methods. The study was based on data obtained from 72 patients having chronic rhinosinusitis and nasal polyps, who underwent endoscopic functional sinus surgery according to the principles of sparing effect on the periosteum in the alveolar bay (periosteum-preserving technology). The patients were divided into two groups: I group included 35 patients subjected to shaver polypectomy; II group consisted of 37 individuals operated on by standard conventional method. Results. The average total Lund-Mackay (LM) score before endoscopic rhinosurgery in I group was 14.57±0.52 scores, and 13.32±0.6 scores in the II group. It went down to 4.26±0.38 in I group and to 4.61±0.39 in II group (p <0.05) 3 months after the intervention. In the 6th month of post-surgical follow up there was a significant increase in the total LM score in the patients of II group up to 6.84±0.6 that indicates a more stable result after shaver-assisted sinusotomy. The incidence of sinus lifting complications after endoscopic polypectomy was 24.32±7.05% of cases in the patients of I group compared to the individuals of II group having 2 37.14±8.17% of complicated cases (p <0.05). Sinus lifting and dental implant placement were found out to be effective in all patients of I group and in 94.29±3.92% of patients in the II group. Conclusions. Endoscopic intervention stuck to principles of preserving periosteum and providing appropriate therapeutic support to patients with chronic rhinosinusitis under control allows oral surgeons to perform safe dental implant placement with subantral bone augmentation. Applying shaver-assisted periosteum-preserving technique for surgical treatment of patients with chronic rhinosinusitis and nasal polyps provides a longer clinical effect and reduces the incidence of postoperative complications of subantral bone augmentation by 12.82%.