The ENT's role in sinus lift management doesn't need misleading messages

摘要

Dear Editor,i read with great attention the article by g. Felisati et al..1, Maxillary sinus elevation in conjunction with transnasal endoscopic treatment of rhino-sinusal pathoses: prelimi-nary results on 10 consecutively treated patients.The article supports, quite surprisingly, the possibility of combining functional endoscopic sinus surgery (to treat local contraindications to sinus augmentation) simultane-ously with the sinus lift procedure itself in order to avoid a double procedure. As clearly reported in the article, "EnT assessment in the integrated management of candidate for (maxillary) sinus lift".2, the first EnT publication dealing systematically with this emerging interdisciplinary topic ac-cording to the Messerklinger philosophy, in order to avoid postoperative complications of the sinus lift procedure, per se apt to jeopardize the delicate homeostasis of the maxil-lary sinus, "the concomitant presence of systemic, naso-si-nusal or maxillary sinus diseases" representing potentially reversible contraindications, must be first detected (the first preventive-diagnostic step), and then corrected (the second preventive-therapeutic) "in order to restore the physiologi-cal drainage and ventilation of the maxillary sinus". only after the verified reestablishment of these last conditions can the patient be submitted to the sinus lift operation.According this protocol accepted worldwide, developed by the italian EnT School of Milan, any surgical ma-noeuvre apt to compromise the delicate homeostasis of the nose and the maxillary sinus must be formally con-traindicated in conjunction with the sinus lift procedure, because responsible of possible iatrogenic complications and failure of the implantologic rehabilitation.As reported in the same article the "anatomic alterations that impair physiological maxillary drainage and are re-sponsible for sinus dysventilation" must be corrected be-fore sinus lift "in case of associated sinus diseases".