scholarly journals Endoscopic Trans-Turbinal Medial Maxillectomy: A Modified Endoscopic Medial Maxillectomy Technique to Preserve the Inferior Turbinate

2021 ◽  
Vol 64 (12) ◽  
pp. 959-964
Author(s):  
Ki Ju Cho ◽  
Hyun-Jin Cho ◽  
Yeon-Hee Joo ◽  
Yung Jin Jeon ◽  
Sea-Yuong Jeon ◽  
...  
Keyword(s):  
Maxillary Antrum ◽  
Maxillary Sinusitis ◽  
Surgical Techniques ◽  
Inferior Turbinate ◽  
Complete Removal ◽  
Nasolacrimal Duct ◽  
Nasal Valve ◽  
Mucosal Flap ◽  
Medial Maxillectomy ◽  
Valve Area

Endoscopic medial maxillectomy (EMM) and its modifications are surgical techniques are used to treat recalcitrant maxillary sinusitis as well as maxillary sinus tumors. In this report, we propose a simple and efficient modification of EMM, called endoscopic trans-turbinal medial maxillectomy (ETTMM), by which the inferior turbinate (IT), nasolacrimal duct, and anatomical integrity of the nasal valve area are preserved. A total of 10 patients (five tumorous and five nontumorous maxillary diseases) underwent ETTMM. Briefly, a turbinate mucosal flap on the superior aspect of the IT was elevated after middle meatal antrostomy. Then a trans-turbinal window was developed to expose the inferior meatus, after which an extended maxillary antrostomy was generated. Finally, the turbinate mucosal flap was repositioned after complete removal of the antral lesions. All lesions were successfully treated using ETTMM. Our modification was easy to perform, and we achieved good endoscopic visualization and accessibility throughout the whole antrum by creating a trans-turbinal window and extended maxillary antrostomy. We could perform postoperative surveillance easily through the wide antrostomy using rigid endoscopes of various angles. ETTMM is a simple and useful modification of EMM that provides clear visualization and great accessibility to most aspects of the maxillary antrum while preserving the nasal functional units, including the IT and nasal valve area.

scholarly journals Reversible Endoscopic Medial Maxillectomy: Endonasal Approach to Diseases of the Maxillary Sinus

2020 ◽  
Vol 24 (02) ◽  
pp. e247-e252 ◽  
Author(s):  
Miguel Soares Tepedino ◽  
Ana Clara Miotello Ferrão ◽  
Hana Caroline Morais Higa ◽  
Leonardo Lopes Balsalobre Filho ◽  
Enrique Iturriaga ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Case Series ◽  
Inferior Turbinate ◽  
Lateral Wall ◽  
Nasolacrimal Duct ◽  
Sinus Disease ◽  
Patient Series ◽  
Medial Maxillectomy ◽  
Maxillary Diseases

Abstract Introduction The endoscopic access has reduced the morbidity associated with external approaches in diseases of the maxillary sinus. A reversible endoscopic medial maxillectomy (REMM) is presented as an alternative for treatment of benign maxillary diseases. Objective To describe the REMM technique and report four cases of patients with benign maxillary sinus conditions treated through this approach. Methods The present study was divided into two parts: anatomical and case series. Two cadaveric dissections confirmed the feasibility of the REMM approach. The same technique was performed on four consecutive patients with benign maxillary sinus disease. Results The cadaveric dissections confirmed wide exposure to the maxillary cavity, preserving the anatomy of the maxillary sinus. In the patient series, one patient presented with an antrochoanal polyp, one had a silent sinus syndrome, one had a chronic maxillary sinusitis secondary to a gunshot, and the last one had an inverted papilloma in the maxillary sinus. In all of the cases, the REMM approach provided excellent access and adequate resection, as well as preservation of the inferior turbinate, nasolacrimal duct, and lateral wall of the nose (including its osteomucosal component). Finally, all of the patients had an uneventful postoperative course. Conclusion The REMM technique is an excellent surgical approach to benign conditions of the maxillary sinus. It has few limitations and appears to be associated with less morbidity than conventional techniques.

scholarly journals Endoscopic modified medial maxillectomy for odontogenic cysts and tumours

2014 ◽  
Vol 52 (4) ◽  
pp. 376-380
Author(s):  
Tsugihama Nakayama ◽  
Nobuyoshi Otori ◽  
Daiya Asaka ◽  
Tetsushi Okushi ◽  
Shin-ichi Haruna
Keyword(s):  
Dentigerous Cyst ◽  
Inferior Turbinate ◽  
Nasolacrimal Duct ◽  
Odontogenic Cysts ◽  
Odontogenic Tumour ◽  
Intraoral Approach ◽  
Safe Technique ◽  
Medial Maxillectomy ◽  
Keratocystic Odontogenic Tumour ◽  
Modified Medial Maxillectomy

Background: Odontogenic maxillary cysts and tumours originate from the tooth root and have traditionally been treated through an intraoral approach. Here, we report the efficacy and utility of endoscopic modified medial maxillectomy (EMMM) for the treatment of odontogenic maxillary cysts and a tumour. Methodology: We undertook EMMM under general anaesthesia in six patients: four had radicular cysts, one had a dentigerous cyst, and one had a keratocystic odontogenic tumour. Results: The cysts and tumours were completely excised and the inferior turbinate and nasolacrimal duct were preserved in all patients. There were no peri- or postoperative complications, and no incidences of recurrence. Conclusion: Endoscopic modified medial maxillectomy appears to be an effective and safe technique for treating odontogenic cysts and tumours.

scholarly journals Modified transnasal endoscopic medial maxillectomy with medial shift of preserved inferior turbinate and nasolacrimal duct

2011 ◽  
Vol 121 (11) ◽  
pp. 2399-2401 ◽  
Author(s):  
Motohiko Suzuki ◽  
Yoshihisa Nakamura ◽  
Meiho Nakayama ◽  
Akira Inagaki ◽  
Shingo Murakami ◽  
...  
Keyword(s):  
Inferior Turbinate ◽  
Nasolacrimal Duct ◽  
Medial Maxillectomy

Inspiratory and Fixed Nasal Valve Collapse: Clinical and Rhinometric Assessment

2005 ◽  
Vol 19 (4) ◽  
pp. 370-374 ◽  
Author(s):  
Ramakrishnan Vidyasagar ◽  
Michael Friedman ◽  
Hani Ibrahim ◽  
Darius Bliznikas ◽  
Ninos J. Joseph
Keyword(s):  
Inferior Turbinate ◽  
Nasal Valve ◽  
Dual Mode ◽  
Cross Sectional ◽  
Turbinate Hypertrophy ◽  
Number Of Patients ◽  
Inferior Turbinate Hypertrophy ◽  
Nasal Valve Collapse ◽  
External Nasal Valve ◽  
Valve Area

Background Acoustic rhinometry (AR) has been used to assess nasal valve obstruction. Standard AR measurement of the cross-sectional area (CSA) of the nasal valve is done in the apneic phase, whereas collapse often occurs on inspiration. We used the ratio of the CSA obtained during active inspiration and during apnea to compute a more meaningful method of diagnosing nasal valve collapse. Methods AR was performed in 40 patients without nasal valve obstruction and 47 patients diagnosed with nasal valve obstruction. Patients with septal deflection or anterior inferior turbinate hypertrophy were excluded. The internal and external nasal valve area was observed during apnea and on active inspiration. AR measurement of the CSA of both nasal valves was performed during the apneic phase and during active inspiration and the CSA (inspiratory)/CSA (apneic) ratio was calculated. Results The CSA (inspiratory)/CSA (apneic) ratio was ≥1 in normal patients and in patients with fixed nasal valve collapse. The ratio was <1 in patients with inspiratory collapse. Data from history, physical examination, and dual-mode AR testing successfully differentiated patients into (1) normal valves, (2) fixed valve collapse, and (3) inspiratory valve collapse. A large number of patients with collapse had both internal and external valve obstruction and a large number also had a combination of inspiratory and fixed collapse. Conclusion Dual-mode AR testing is an effective tool in more precisely identifying nasal valve obstruction and is the first objective test shown to be highly diagnostic of inspiratory nasal valve collapse.

Endoscopic Medial Maxillectomy with Preservation of Inferior Turbinate and Nasolacrimal Duct

2012 ◽  
Vol 26 (5) ◽  
pp. 405-408 ◽  
Author(s):  
Tsuguhisa Nakayama ◽  
Daiya Asaka ◽  
Tetsushi Okushi ◽  
Mamoru Yoshikawa ◽  
Hiroshi Moriyama ◽  
...  
Keyword(s):  
Inferior Turbinate ◽  
Nasolacrimal Duct ◽  
Medial Maxillectomy

Endoscopic medial maxillectomy in patients treated at the Otorhinolaryngology and Laryngological Oncology Clinic of Military Institute of Medicine in Warsaw in the years 2008–2018

2020 ◽  
Vol 74 (4) ◽  
pp. 25-30 ◽  
Author(s):  
Agnieszka Witkowska ◽  
Kornel Szczygielski ◽  
Dariusz Jurkiewicz
Keyword(s):  
Maxillary Sinus ◽  
Retrospective Analysis ◽  
Maxillary Antrum ◽  
Maxillary Sinusitis ◽  
Institute Of Medicine ◽  
Lacrimal Apparatus ◽  
Medial Maxillectomy ◽  
Ethmoidal Arteries ◽  
Military Institute ◽  
Histological Result

<b>Introduction:</b> Endoscopic medial maxillectomy (EMM) refers to surgical resection of the medial wall of the maxillary antrum. The primary indications for EMM are recalcitrant maxillary sinusitis, ablation of malignant and specific benign diagnoses such as Schneiderian Papilloma. Maxillectomy is potentially complicated by injuries to the orbital contents, lacrimal apparatus, optic nerve, ethmoidal arteries that may be accompanied by brisk bleeding. <br><b>Aim:</b> The purpose of this paper is to conduct a retrospective analysis of patients treated with EMM surgery at the Otorhinolaryngology and Laryngological Oncology Clinic of Military Institute of Medicine in Warsaw in the years 2008–2018. <br><b>Material and methods:</b> The retrospective analysis was conducted on patients who underwent EMM treated at the the Otorhinolaryngology and Laryngological Oncology Clinic of Military Institute of Medicine in Warsaw in the years 2008–2018. The research included 18 patients aged 15–94; 8 women and 10 men. <br><b>Results:</b> Out of 18 patients, 8 had been operated before EMM. 16 of them presented with histological examinations, though 5 of which were not confirmed with postoperative histological result. The most common indication for the operation was inverted papilloma. <br><b>Conclusion:</b> Endoscopic surgical approach is effective and precious way to manage tumors which involve the neighboring structures especially medial maxillary sinus. EMM itself is a safe surgical method in managing maxillary sinus disorders and is favored for its decreased invasiveness and avoidance of the deformity of face.

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.

scholarly journals Changing Trends in Endoscopic Endonasal Medial Maxillectomy

2016 ◽  
Vol 9 (1) ◽  
pp. 56-58
Author(s):  
Hitesh Verma ◽  
TM Arun ◽  
Amrinder Kaur
Keyword(s):  
Traditional Approach ◽  
Inferior Turbinate ◽  
Nasolacrimal Duct ◽  
Lateral Nasal Wall ◽  
Endoscopic Endonasal ◽  
Changing Trends ◽  
Alternative Approach ◽  
Medial Maxillectomy ◽  
The Right ◽  
Ethmoid Sinuses

ABSTRACT Medial maxillectomy is a surgical resection of the medial walls of the maxillary bone, medial part of the orbital floor, and ethmoid sinuses. Lateral rhinotomy or sublabial degloving is the traditional approach used for an open medial maxillectomy. Endoscopic medial maxillectomy is used as an alternative approach with similar cure rate with less morbidity. We report here a case of inverted papilloma of the medial wall of the right maxillary sinus where the disease clearance was done with preservative of nasolacrimal duct, inferior turbinate, and lateral nasal wall mucosa by the endoscopic medial maxillectomy approach. How to cite this article Verma H, Dass A, Singhal SK, Gupta N, Arun TM, Kaur A. Changing Trends in Endoscopic Endonasal Medial Maxillectomy. Clin Rhinol An Int J 2016;9(1):56-58.

Pyriform Aperture Enlargement for Internal Nasal Valve Obstruction in Adults: Systematic Review and Surgical Classification

2021 ◽  
pp. 019459982199473
Author(s):  
Humoud Hajem ◽  
Charles Botter ◽  
Mohammad Al Omani ◽  
Vincent Sounthakith ◽  
Eléonore de Bressieux ◽  
...  
Keyword(s):  
Systematic Review ◽  
Nasal Obstruction ◽  
Surgical Techniques ◽  
Major Complication ◽  
Inferior Turbinate ◽  
Lateral Nasal Wall ◽  
Safe Procedure ◽  
Nasal Valve ◽  
Level Of Evidence ◽  
Pyriform Aperture

Objective Pyriform aperture enlargement or “pyriplasty” is an uncommonly used procedure for internal nasal valve obstruction in adults besides functional rhinoplasty, inferior turbinate reduction, and septoplasty. A systematic review of the literature was performed to analyze current surgical techniques, their suggested indications, and their related outcome in terms of success and complications. Data Sources The search was performed on PubMed, EMBASE, SCOPUS, and Cochrane databases. Review Methods The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies on congenital, traumatic, tumoral, or infectious internal nasal valve obstruction were excluded. Results Eight articles were finally included. Three types of pyriplasty have been described according to the level of bone resection: low-level pyriplasty through the sublabial approach, mid-level pyriplasty through endonasal approach, and extended pyriplasty through either approach. Indications included (1) clinically or radiologically narrow pyriform aperture, (2) previously unsuccessful internal nasal valve surgery, (3) lateral nasal wall collapse, and (4) inferior turbinate’s head hypertrophy. Subjective improvement of nasal obstruction was reported in these 4 indications. No major complication was encountered. Conclusion Pyriplasty for nasal obstruction is a simple and safe procedure that could be effective in selected cases. However, level of evidence is currently low, and success rate may vary with indications and pyriplasty techniques. Moreover, there is no clear definition of normal pyriform aperture dimensions to date. Further prospective studies are thereby necessary and should include radiological analysis of pyriform aperture and validated nasal obstruction measurement tools.

Minimally invasive transnasal approach to infratemporal fossa abscess

2015 ◽  
Vol 129 (8) ◽  
pp. 812-816 ◽  
Author(s):  
K Nomura ◽  
H Hidaka ◽  
Y Takata ◽  
Y Katori
Keyword(s):  
Minimally Invasive ◽  
Infratemporal Fossa ◽  
Inferior Turbinate ◽  
Nasolacrimal Duct ◽  
Field Of View ◽  
Transnasal Approach ◽  
Invasive Method ◽  
Previously Treated ◽  
Medial Maxillectomy ◽  
Modified Medial Maxillectomy

AbstractBackground:Infratemporal fossa abscess following odontogenic infection is not rare, and usually occurs as a sequela of dental disease. Infratemporal fossa abscess was previously treated with the combination of buccal incision and temporal incision, or via a transoral approach.Method:This paper reports a case of infratemporal fossa abscess in a 51-year-old female.Results:The abscess was drained transnasally via an endoscopic modified medial maxillectomy approach, preserving the inferior turbinate and nasolacrimal duct. The pain remitted the next day and trismus had diminished in one week.Conclusion:The transnasal approach with endoscopic modified medial maxillectomy is a direct, minimally invasive method that provides a direct field of view for drainage of infratemporal fossa abscess. This approach is recommended for infratemporal fossa abscess.

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