METHOD FOR SURGICAL MANAGEMENT OF CHRONIC MAXILLARY SINUSITIS THROUGH NATURAL JUNCTION WITH USING TEMPORARY SILICONE IMPLANT

摘要

FIELD: medicine.;SUBSTANCE: ostio-meatal complex is locally anaesthetised. A patient is anaesthetised endotracheally. An incision 0.3-0.5 cm is made at a distance from a border of a semilunar hiatus. A free end of a hamulus is passed around. The incision is extended 0.1-0.2 cm from a base vertically downwards. And it goes further 0.4-0.6 cm along a free border of a lower nasal concha. The hamulus is pulled by blunt dissection in the lateral direction posteriorly. A view of a closed portion of bulla ethmoidalis and a natural junction of a maxillary sinus is opened. That is followed by assessing the changes of the mucous membrane within the semilunar hiatus, the closed portion of bulla ethmoidalis and the natural junction with the maxillary sinus. A microdebrider or an abrasion spoon is used to remove the changed mucous membrane up to a bony frame. The maxillary sinus is inspected through the natural junction. The pathologically involved tissues are removed. The maxillary sinus is rinsed. A temporary silicone implant is mounted. The hamulus is placed in its initial position. The incision is sutured. The sutures are removed 7 days later. The silicone implant is removed 14 days later. A middle nasal passage is endoscopically inspected. The maxillary sinus is rinsed through the natural junction with an antiseptic solution. The check-up examination is performed 6 and 12 months after the operation.;EFFECT: improving the quality of the treatment, reducing the time of staying in hospital, reducing the number of postoperative complications and recurrences by endoscopic intervention, opening the maxillary sinus within the natural junction, preserving the hamulus, and avoiding the postoperative stenosis by using the silicone implant.;2 ex