scholarly journals Evaluation of mucociliary clearance in the postoperative period after a maxillary sinus surgery

2020 ◽  
Vol 5 (1) ◽  
pp. 23-27
Author(s):  
Oleg V. Mareev ◽  
Gleb O. Mareev ◽  
Ivan V. Fedosov ◽  
Igor Yu. Ermakov
Keyword(s):  
Maxillary Sinus ◽  
Postoperative Period ◽  
Mucociliary Clearance ◽  
Video Recording ◽  
Sinus Surgery ◽  
Control Group ◽  
Surgical Interventions ◽  
Brush Biopsy ◽  
Endoscopic Control ◽  
Maxillary Sinuses

Objectives - evaluation of the local function of the mucociliary clearance (MCC) in the postoperative period in patients with foreign bodies in the maxillary sinuses, who have undergone various surgical treatment. Material and methods. Using an original analysis technique for highspeed digital video recording of a microscopic picture of a specimen, obtained by brush biopsy from specific regions of the nasal cavity and paranasal sinus under endoscopic control, the MCC of the nasal mucosa was evaluated in the control group (n=60) and in the group of patients, who received various surgery (n=60) of maxillary sinuses. Results. We obtained the data on persistent and apparent local MCC disorders in the field of the surgical intervention in the postoperative period. Conclusion. Surgical interventions with access not in the area of the natural ostium of the maxillary sinus are more gentle, since they do not injure the mucociliary clearance in the key region - the ostium.

Reevaluation of Maxillary Sinus Surgery: Experimental Study in Rabbits

1989 ◽  
Vol 98 (11) ◽  
pp. 901-906 ◽  
Author(s):  
David W. Kennedy ◽  
Hisham Shaalan
Keyword(s):  
Maxillary Sinus ◽  
Complex Disease ◽  
Mucociliary Clearance ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Control Group ◽  
Ostiomeatal Complex ◽  
The Status ◽  
Sinus Ostium ◽  
Sinus Mucosa

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.

Early Effect of Exogenous Na Hyaluronate on Mucociliary Clearance

2005 ◽  
Vol 19 (3) ◽  
pp. 244-247 ◽  
Author(s):  
Altan Yildirim ◽  
Bulent Turgut ◽  
Ali Ihsan Bebek ◽  
Cesur Gumus ◽  
Sinan Kocaturk ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Surgical Procedure ◽  
Mucociliary Clearance ◽  
Physiological Solution ◽  
Control Group ◽  
Scintigraphic Imaging ◽  
Early Effect ◽  
Significant Difference ◽  
The Mean ◽  
Maxillary Sinuses

Background An animal study is performed to determine the early effect of 1% Na hyaluronate on mucociliary clearance function. Methods One percent of Na hyaluronate was introduced into the maxillary sinuses of rabbits by anterior antrostomy. A physiological solution of 1% NaCl was introduced into the maxillary sinuses of a control group to equalize the influence of Na for both groups. The treatment material was sprayed with an atomizer for coating the maxillary sinus lining. Technetium-99m diethylenetriamine pentaacetate dynamic scintigraphic imaging was performed to evaluate mucociliary clearance function on all rabbits 72 hours after the surgical procedure. Results Although the mean rate of mucociliary clearance of the Na hyaluronate group was slightly worse than the control group; there was no statistically significant difference between them. Conclusion There is no early effect of exogenous 1% Na hyaluronate on mucociliary clearance function.

Endonasal endoscopic surgery with combined middle and inferior meatal antrostomies for fungal maxillary sinusitis

2015 ◽  
Vol 129 (S2) ◽  
pp. S52-S55 ◽  
Author(s):  
M Sawatsubashi ◽  
D Murakami ◽  
T Umezaki ◽  
S Komune
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Sinus Surgery ◽  
Control Group ◽  
Fungus Ball ◽  
Non Invasive ◽  
Middle Meatal Antrostomy ◽  
Mucosal Thickening ◽  
Fungus Balls ◽  
Maxillary Sinuses

AbstractObjective:The purpose of this study was to evaluate the effectiveness of the combination of inferior and middle meatal antrostomies for treatment of a maxillary sinus fungus ball by functional endoscopic sinus surgery.Methods:A retrospective analysis including 28 patients with non-invasive fungal maxillary sinusitis was performed. Fourteen patients underwent FESS with both middle and inferior meatal antrostomies (combined group). The remaining 14 patients were treated with FESS through only the middle meatal antrostomy (control group).Results:Post-operative computed tomography showed normal maxillary sinuses in all patients in the combined group. In contrast, in the control group, five patients (36 per cent) exhibited a normal maxillary sinus, seven (50 per cent) showed maxillary mucosal thickening and two (14 per cent) had persistent fungus balls in the maxillary sinus.Conclusion:FESS with a combination of middle and inferior meatal antrostomies proved more effective for treating fungal maxillary sinusitis.

Optimization of postoperative management of patients undergoing functional endoscopic sinus surgery

2018 ◽  
pp. 26-31
Author(s):  
Sergey Bezshapochny ◽  
Andrey Loburets ◽  
Valery Loburets
Keyword(s):  
Nasal Cavity ◽  
Postoperative Period ◽  
Sodium Hyaluronate ◽  
Sinus Surgery ◽  
Control Group ◽  
Nasal Breathing ◽  
Traditional Therapy ◽  
Significant Difference ◽  
Water Salt ◽  
Experimental Group

Topicality: The result of surgical treatment depends largely on the chosen method of management of the postoperative period, the main purpose of which is to reduce the effects of surgical trauma. Despite the wide variety of drugs for local and systemic use, the question of pharmacotherapy of the operated sinus remains open to this day. The main properties that a modern drug should possess are safety and high clinical efficacy. Aim: to study the clinical efficacy of topical application of a complex preparation based on a saline solution containing sodium hyaluronate and dexpanthenol in patients with chronic sinusitis after functional endoscopic sinus surgery (FESS). Materials and Methods: Clinical and laboratory studies were conducted on 47 patients with chronic rhinosinusitis who underwent surgery using the FESS technique. Patients were divided into 2 groups according to the principle of the postoperative period. Patients of research group (n=21), except for traditional therapy, was used locally NASOMER (a preparation based on a water-salt solution containing sodium hyaluronate and dexpanthenol); to the control group (n=26) patients entered, in the postoperative period received traditional therapy. Traditional therapy included a toilet of the nasal cavity, the use of short-course topical decongestants, irrigation of the nasal cavity with water-salt solutions. Criteria of clinical effectiveness: data of endoscopy of the nasal cavity, rhinomanometry, activity of the mucociliary transport system. The effectiveness of functional research methods in the postoperative period was determined on the 7th and 14th day of treatment. Results: On the 3rd day of the study, an increase in the swelling of the nasal cavity was observed in patients of both clinical groups, correlated with difficulty in nasal breathing. On the 7th day, a decrease in edema was observed in patients of both groups, but in the experimental group, the index of nasal breathing, according to rhinomanometry, was significantly (p<0.05) different from the control group, and was respectively 1.54±0.14 and 2.04±0.19 kPa/l*s. On the 14th day of the study, no significant difference was observed between these indicators. When studying the activity of the ciliated epithelium of the mucous membrane of the nasal cavity, it was proved that patients of the experimental group on day 7 after surgery showed a statistically significant difference in this indicator compared to the control group (17.8±1.0 and 22.7±2.1 min. respectively). Conclusions: The use of NASOMER after surgical intervention in patients with chronic rhinosinusitis contributes to more effective treatment compared with traditional therapy, as evidenced by the rapid recovery of the main functional parameters according to active posterior rhinomanometry and mucociliary clearance. Based on the results of the studies performed, the use of NASOMER for pharmacotherapy in the postoperative period is recommended for patients who have undergone rhinosurgical interventions with the aim of reducing the period of postoperative rehabilitation as an effective anti-inflammatory and wound-healing agent.

scholarly journals Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS

2021 ◽  
pp. 014556132098603
Author(s):  
Anni Koskinen ◽  
Marie Lundberg ◽  
Markus Lilja ◽  
Jyri Myller ◽  
Matti Penttilä ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Revision Surgery ◽  
University Hospital ◽  
Sinus Surgery ◽  
Control Group ◽  
University Hospitals ◽  
Balloon Sinuplasty ◽  
Long Term Follow Up

Objectives: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique. Methods: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011. Results: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation. Conclusion: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.

scholarly journals ТREATMENT OF STENOSIS OF THE PYLORIC BULBAR ZONE OF ULCERATIVE GENESIS USING MINIMALLY INVASIVE SURGERY

2020 ◽  
pp. 167-175
Author(s):  
O. M. Babii ◽  
S. A. Tarabarov ◽  
N. V. Prolom ◽  
B. F. Shevchenko ◽  
A. A. Galinsky
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Clinical Signs ◽  
State Institution ◽  
Disease Recurrence ◽  
Control Group ◽  
Surgical Interventions ◽  
Remote Observation

Summary. Purpose: to improve the results of surgical treatment of stenosis of the pyloroduodenal zone of ulcerative origin through the use of minimally invasive laparoendoscopic interventions. Material and methods. In the Department of Surgery of the Digestive Organs of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” for 2014-2019, 114 patients with stenosis of the pyloroduodenal zone of ulcerative origin were examined. Of these, 35 — with compensated stenosis, 57 — with subcompensated, 22 — with decompensated stenosis. The average age (45.3±5.2) years. The control group consisted of 20 healthy individuals. All patients underwent surgical treatment using minimally invasive and traditional surgical interventions. Results and discussion. During the study, known indications were clarified and new indications for performing endoscopic balloon pyloroduodenoplasty and combined laparoendoscopic intervention were clarified. Complications in the immediate postoperative period occurred in 1 patient (1.04%) in the form of perforation of the dilated zone. In patients after the traditional laparotomy surgery, the average postoperative period was (15 ± 2) days. Complications in the immediate postoperative period occurred in 2 patients (11.1 %) in the form of bleeding and leaks in the pyloroplasty zone, which required repeated surgical treatment. Тhere were no fatal cases. The remote observation period was 7-22 months. Endoscopic, radiological and clinical signs of recurrence of peptic ulcer and stenosis were not detected. Conclusions. The method of minimally invasive endoscopic and combined laparoendoscopic interventions in the treatment of stenosis of the pyloroduodenal zone of ulcerative genesis is characterized by a minimal number of complications, has good efficacy indicators and the absence of disease recurrence in the long-term period.

Restoration of the mucociliary clearance ofthe maxillary sinus after endoscopic sinus surgery

1997 ◽  
Vol 99 (1) ◽  
pp. 48-52 ◽  
Author(s):  
K IKEDA ◽  
T OSHIMA ◽  
M FURUKAWA ◽  
Y KATORI ◽  
A SHIMOMURA ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Mucociliary Clearance ◽  
Sinus Surgery

scholarly journals Disease Management in the Fungal Body of the Maxillary Sinus in People with Planned Dental Implantation

2021 ◽  
Vol 6 (3) ◽  
pp. 206-211
Author(s):  
Ya. V. Shkorbotun ◽  
◽  
Keyword(s):  
Maxillary Sinus ◽  
Complete Removal ◽  
Sinus Surgery ◽  
Endoscopic Endonasal ◽  
Main Method ◽  
Maxillary Bone ◽  
Fungal Ball ◽  
Dental Implantation ◽  
Group 2 ◽  
Maxillary Sinuses

The fungal ball is the most common clinical form of fungal etiology sinusitis. The main method of treatment of patients with this pathology is surgery. Achieving complete removal of the fungal body is important, especially in patients who will have planned dental implantation. Among the accesses to the maxillary sinus in cases of the fungal body of the sinus, the most common one is through the middle meatus, but it does not provide visual control of the anterior parts of the sinus during the intervention. The use of modified infraturbinal access provides better opportunities for examination of the anterior parts of the maxillary sinus. The purpose of the study is to increase the effectiveness of surgical treatment of patients with fungal bodies of the maxillary sinus by optimizing access during endoscopic endonasal intervention. Materials and methods. The data of 113 patients with fungal ball of maxillary sinuses who underwent sinusotomy in preparation for dental implantation were analyzed. Cone beam computed tomography of paranasal sinuses of patients were performed twice – before functional endoscopic sinus surgery and before subantral augmentation of the maxillary bone. Group 1 included 78 patients to whom the fungal balls were removed from the sinus through the middle nasal meatus, group 2 – 35 patients to whom, in cases when it was impossible to visually confirm the completeness of removal of the fungal ball from the anterior area of the sinus, an additional infraturbinal approach was performed in our modification. Results and discussion. According to tomography before rhinosurgery it was established that "blackout" of more than 60% of the sinus space is observed in 50.5% of patients with fungal bodies, with the vast majority of patients (88.1%) fungal bodies in the maxillary sinus are located in its lower parts and spread forward from the nasolacrimal canal level. During sinus rehabilitation, the need for additional infraturbinal access arose in 5 (14.3%) patients of the second group. As a result of its performance in all 5 operated patients polyposis-altered tissues were found in "blind zones" and in 2 (5.7%) – there were also remains of a fungal body. Residual fungal bodies in the maxillary sinus were detected in 3 (3.9% CI 95% – 0.01; 11.6) patients of the first group, and were not observed in the second group. All cases of residual fungal masses in the sinus were not accompanied by specific complaints. A revision of sinusitis with fungal masses removing was performed on 3 patients due to the appearance of residual fungal bodies by preformed antrostomy with local anesthesia. Conclusion. Anthrostomy using additional endoscopic infraturbinal access when removing the fungal body from the lower anterior maxillary sinus is the optimal combined access that allows maximum visualization of the maxillary sinus and avoid recurrence of the disease

Predicting results of intra-sinus implantation

2021 ◽  
Vol 20 (3) ◽  
pp. 59-63
Author(s):  
М. А. Likhanova ◽  
◽  
К. А. Sivolapov ◽  
Keyword(s):  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Mucociliary Clearance ◽  
Physiological State ◽  
The State ◽  
Factors Affecting ◽  
Functional Methods ◽  
Cone Beam Computerized Tomography ◽  
Maxillary Sinuses

The study included 564 patients with a deficit in the volume of bone tissue of the alveolar process of the maxillary bone, which did not allow simultaneous installation of crestal implants. The work was carried out relying on modern forecasting systems based on an aggregate and quantitative assessment of the risk of intra- and postoperative complications, anatomical and physiological state of tissues and organs in the area of intervention. In the course of the study, a system for predicting the results of subaxillary augmentation was developed. Factors affecting the nature and frequency of complications in the immediate and long-term postoperative periods are highlighted. A comparative assessment of the functioning of the mucociliary clearance depending on the volume and location of the augmentate is given. Functional methods of investigation – spiral computed tomography and cone-beam computerized tomography – of maxillary bones, video endoscopy of the nasal cavity, study of mucociliary clearance, anterior active rhinomanometry were used. The assessment of the state of the augmentate, pneumatization of the maxillary sinuses, the anatomy of the nasal cavity, paranasal sinuses, the state of the maxillary sinus mucosa, the vertical volume of the walls of the maxillary sinus, and the evacuation capacity of the maxillary sinuses were evaluated. A score was determined for each of the studied parameters. Patterns of preoperative changes in the maxillary sinuses that led to complications in the postoperative period were identified. For each of these parameters, the amount of points collected can range from 1 to 5 points. The higher the score, the higher the probability of successful surgical treatment. If the sum of points is from 1 to 2, forecast of subaxillary augmentation is unfavourable, for 3 points is questionable, with a score of 4–5, the prognosis is favourable.

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