scholarly journals Conchopexy Suture versus Bolgerization in preventing middle turbinate lateralisation following FESS

2021 ◽  
Vol 4 (4) ◽  
pp. 148-153
Author(s):  
R.K. Mahaseth ◽  
U. Gurung ◽  
B. Pradhan

Background: Middle turbinate lateralisation is the most common minor post-operative complication following functional endoscopic sinus surgery. This study aimed to compare the outcome between Conchopexy suture and Bolgerization method in preventing middle turbinate lateralisation. Methodology: This was a prospective, comparative and interventional study conducted from May 2018 to November 2019 at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. A total of 68 patients were divided equally into two groups. Following functional endoscopic sinus surgery, the middle turbinate was medialised either by Conchopexy suture or Bolgerization technique. Postoperative assessment was done on the second and 12th week of surgery, where the position of the middle turbinate and status of the sinus cavity were assessed using perioperative sinus endoscopic (POSE) score. Chi-square test and unpaired t test were used for comparison of postoperative results between two groups taking p value of < 0.05 as statistically significant. Results: Lateralised middle turbinate and mean POSE score was 5/34 (14.8%) and 2.1±1.25, respectively, in Conchopexy group whilst in Bolgerization group it was 6/34 (17.6%) and 2.5±1.46. However, the observed differences were not statistically significant. Conclusion: Conchopexy suture and Bolgerization techniques were equally effective in preventing middle turbinate lateralisation. Hence, either of these techniques could be used as an adjunct to FESS to avoid middle turbinate lateralisation.

1998 ◽  
Vol 112 (9) ◽  
pp. 845-848 ◽  
Author(s):  
Rong-San Jiang ◽  
Chen-Yt Hsu ◽  
Jinq-Wen JANG

AbstractThe bacteriology of chronic sinusitis was studied by using swab and mucosalspecimens from both the maxillary and ethmoid sinuses. The specimens of the maxillary sinus were taken through translabial antroscopy. The specimens of the ethmoid sinus were taken after removing the ethmoid bulla during functional endoscopic sinus surgery (FESS). Eighty-six samples of each type of specimen were collected. Among the maxillary sinus samples, the culture rate was 60.5 per cent from the swab specimens and 36 per cent from the mucosal specimens. Among the ethmoid sinus samples, the culture rate was 58.1 per cent from the swab specimens and 75.6 per cent from the mucosal. The p-value by the Chi-Square test is higher than 0.01 (p =0.015). As there were more isolates ofStaphylococcus epidermidisfrom the mucosal specimens, they are not a better choice of specimen for sampling the ethmoid sinus than a swab specimen.


1996 ◽  
Vol 75 (1) ◽  
pp. 42-44 ◽  
Author(s):  
John H. Krouse ◽  
Dewey A. Christmas

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.


2016 ◽  
Vol 9 (1) ◽  
pp. 28-32 ◽  
Author(s):  
V Narendrakumar ◽  
V Subramanian

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.


2016 ◽  
Vol 6 (21) ◽  
pp. 41-43
Author(s):  
Carlos Miguel Chiesa Estomba ◽  
Frank Alberto Betances Reinoso ◽  
Carmelo Santidrian Hidalgo

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.


2021 ◽  
Vol 4 (2) ◽  
pp. 365-370
Author(s):  
Baseem Natheer Abdulhadi ◽  
Ali Ibrahim Shyaa ◽  
Laith ALTamimi

Background: Among the most popular methods employed to classify the depth of the olfactory fossa is Keros classification. This study aims to assess Keros classification of the ethmoid roof, any possible association between Keros types and gender, and the incidence of asymmetry between right and left sides among Iraqi patients.  Methods: A retrospective cross-sectional study was conducted at Al-Shaheed Gazi Al-Hariri Teaching Hospital, Medical City, Baghdad, Iraq. The archived reports and the CT scans images (nose and paranasal sinuses) of 126 patients who have undergone functional endoscopic sinus surgery between January 2019 and January 2020 were reviewed. Univariate and bivariate statistical analysis was performed using SPSS version 24. The statistically significant was considered at less than 0.05. Results: More than half of patients were females (54.0%) with a mean age of 31.52 ± 11.38 (SD) years (range: 10-57 years). Among the total patients, the mean depth of olfactory fossa (OF) was 3.58 ± 0.02 mm. Results showed that Keros type I was the most common type (71.0%), followed by type II (27.4%) and type III (1.6%) respectively. The difference in the olfactory fossa depth between the right and left sides was ≥ 1 mm in 16 (12.7%) patients and < 1 mm in 110 (87.3%) patients. Moreover, there was no significant relation between symmetry/asymmetry and gender ( p-value > 0.05). Conclusion: Keros type I was the most common type, which carries the lowest risk of inadvertent intracranial injury during endoscopic sinus surgery; besides the relatively low percentage of asymmetry in the depth of the two olfactory fossae among patients, surgeons should always be cautious during surgery to avoid iatrogenic injury concerning the thin lateral lamella of the cribriform plate.


2016 ◽  
Vol 9 (1) ◽  
pp. 21-23
Author(s):  
Rahul Shivaraj ◽  
Cimona Dsouza ◽  
George Pinto

ABSTRACT Objective The superior attachment of the uncinate process and the agger nasi cell are important landmarks in frontal sinus surgery and are in close relation with each other. The aim of this study is to investigate the relationship between the two. Study design A retrospective radiological study. Materials and methods A total of 50 patients with features of chronic sinusitis were evaluated radiographically, i.e., by computed tomography. Hundred sides, i.e., 50 scans, were evaluated for superior attachment of the uncinate process and the presence of agger nasi. Chi-square test was used as a statistical tool for eliciting the relationship between the two. Results The agger nasi cell was found in 68 (68%) of 100 sides. The prevalence of agger nasi cell according to the superior attachment of uncinate process types was 64.1% for lamina papyracea, 79.41% for skull base, and 53.84% for middle turbinate. The presence of agger nasi cell according to the superior attachment types of uncinate process was not statistically significant (X2 = 3.5925, p = 0.16592). Conclusion The agger nasi cell was found in 68 sides (68%), and there was no statistical significance between the superior attachment of the uncinate process and the presence of agger nasi cell. How to cite this article Shivaraj R, Dsouza C, Pinto G. Influence of Superior Attachment of the Uncinate Process on the Presence of Agger Nasi. Clin Rhinol An Int J 2016;9(1):21-23.


Author(s):  
Armando T. Isla ◽  
Josefino G. Hernandez

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.  


2021 ◽  
Vol VOLUME 9 (ISSUE 1) ◽  
pp. 6-12

INTRODUCTION: Rhinogenic headaches are basically described as headache or facial pain caused by rhinological source. The presence of nasal symptoms & it’s temporal relationship with headache is the key factor that can guide the diagnosis and patient management. AIMS: This study aims to evaluate the efficacy of Septoplasty with Functional endoscopic sinus surgery (F.E.S.S) in the management of Rhinogenic headache. MATERIALS & METHODS: It was a Prospective study conducted in M.G.M Medical College & associated M.Y group of hospitals from March 2019 to March 2020. 64 patients of age group 18 years to 60 years having chronic rhinosinusitis with headache included in the study. After detailed history and thorough examination, nasal endoscopy and CT Paranasal sinus was done. Patients not responding to conservative management were selected for undergoing functional endoscopic sinus surgery. RESULTS: A total of 64 patients were included in the study,34 male & 30 female with the mean age group of 31.4 & 30.1 years respectively. Out of 64 patients,67% were completely free from headache,15% were significantly improved,7% had mild relief & 11% did not show any benefit in headache from surgery. Postoperatively, there was statistically significant difference was found patient’s symptomatology (i.e. p value =0.0165). CONCLUSION: To make the diagnosis both anatomical & infective factors needed to be considered. Correction of obvious anatomic abnormalities in carefully selected patients can significantly improve several important clinical outcomes from abolishing headache completely to decreasing its intensity and frequency of episodes. KEY-WORDS: Rhinogenic headaches, Septoplasty, Chronic rhinosinusitis, F.E.S.S, Nasal endoscopy


Sign in / Sign up

Export Citation Format

Share Document