Transantral revision of recurrent maxillary and ethmoidal disease following functional intranasal surgery.
Otolaryngol Head Neck Surg
; 106(4): 367-71, 1992 Apr.
Article
en En
| MEDLINE
| ID: mdl-1565487
Recurring disease in the maxillary sinus, despite inferior meatal antrostomies, has led to the widespread use of middle meatal antrostomy or simple decompression of the natural ostium of the middle meatus in attempts to restore function to the maxillary sinus. We have reported recurrent disease in the maxillary sinus in patients with stage III or stage IV hyperplastic rhinosinusitis in whom attempts at functional surgery of the middle meatus were unsuccessful in reversal of retrograde changes. One hundred patients who had previously undergone intranasal sphenoethmoidectomy with removal of the middle turbinate, decompression of the maxillary ostium, and removal of overt hyperplastic disease of the middle meatus underwent revision transantral ethmoidectomy. All recurrent or residual diseased mucosa was removed, including polyps, occasional mucoceles, and hyperplastic changes that occurred despite patency of a middle meatal maxillary ostium. In many of these patients the maxillary sinus was widely marsupialized secondarily into the posterior nasal vault. While the initial overall polyp recurrence rate after intranasal sphenoethmoidectomy in these patients was as high as 19.2%, the rate of polyp recurrence after transantral revision was less than 5% in from 18 to 48 months postoperatively. The experience in this series suggests that mucosal changes have played a primary role in unsuccessful treatment, independent of whether or not adequate functional egress for maxillary secretion, drainage, or ventilation has been created or restored.(ABSTRACT TRUNCATED AT 250 WORDS)
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Seno Esfenoidal
/
Sinusitis del Etmoides
/
Sinusitis Maxilar
/
Senos Etmoidales
Límite:
Humans
Idioma:
En
Revista:
Otolaryngol Head Neck Surg
Año:
1992
Tipo del documento:
Article
Pais de publicación:
Reino Unido