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Role of Modified Endoscopic Medial Maxillectomy in persistent chronic maxillary sinusitis

机译:改良内镜下内侧上颌骨切除术在持续性慢性上颌窦炎中的作用

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Objective: Functional endoscopic sinus surgery (FESS) has a long-term high rate of success for symptomatic improvement in patients with medically refractory chronic rhinosinusitis. As the popularity of the technique continues to grow, however, so does the population of patients with postsurgical persistent sinus disease especially in those with a large window for ventilation and drainage. In addition chronic infections of the sinuses especially fungal sinusitis have a higher incidence of recurrence even though a wide maxillary ostium had been performed earlier. This subset of patients often represents a challenge to the otorhinolaryngologist. We have performed modified endoscopic medial maxillectomy (MEMM) for such patients' with persistent maxillary sinus disease as a means of providing effective drainage and clearance of secretions. Design: A retrospective review was done of all patients with persistent maxillary sinus disease who had undergone modified endoscopic medial maxillectomy between 2009 and 2012. We studied patient demographics, previous surgical history, follow up details and categorized the types of Endoscopic Medial Maxillectomies performed in different disease situations. Subjects and interventions: We performed Modified endoscopic medial maxillectomies (MEMM) in 37 maxillary sinuses of 24 patients. Results: The average age was 43.83 years. Average follow up was 14.58 months.All patients had good disease control in the post operative visits with no clinical evidences of recurrences. Conclusion: Modified endoscopic medial maxillectomy appears to be an effective surgery for treatment of chronic, recalcitrant maxillary sinusitis.
机译:目的:功能性内窥镜鼻窦手术(FESS)对难治性慢性鼻-鼻窦炎患者的症状改善有长期的高成功率。然而,随着该技术的普及持续增长,患有手术后持续性鼻窦疾病的患者人数也在增加,尤其是在那些通气和引流窗口较大的患者中。此外,鼻窦的慢性感染,特别是真菌性鼻窦炎,即使较早进行了广泛的上颌骨口,也有较高的复发率。这部分患者通常代表耳鼻喉科医生的挑战。我们对患有持续性上颌窦疾病的患者进行了改良的内镜下颌上颌内侧切除术(MEMM),以提供有效引流和清除分泌物的手段。设计:回顾性分析所有2009年至2012年间接受改良内镜下上颌内翻切除术的持续性上颌窦疾病患者。我们研究了患者的人口统计学资料,既往手术史,随访细节,并对在不同内镜下进行的内镜上颌窦切开术的类型进行了分类疾病情况。受试者和干预措施:我们对24例患者的37例上颌窦进行了改良内镜下颌内切开术(MEMM)。结果:平均年龄为43.83岁。平均随访时间为14.58个月。所有患者在术后就诊时均具有良好的疾病控制,没有临床证据表明复发。结论:改良的内镜下颌上颌窦切除术似乎是治疗慢性顽固性上颌窦炎的有效方法。

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