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[Maxillary puncture: endoscopic assessment].

O A Ivanchenko, A N Kuzin, A S Lopatin

    Vestnik Otorinolaringologii
    |December 13, 2006
    PubMed
    Summary
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    Maxillary puncture frequently injures the nasolacrimal duct ostium, especially with ostiomeatal complex anomalies. Careful consideration of indications for maxillary puncture is advised in chronic sinusitis cases.

    Area of Science:

    • Otolaryngology
    • Anatomy
    • Surgical Pathology

    Background:

    • Chronic maxillary sinusitis is often linked to anatomical variations within the ostiomeatal complex.
    • Maxillary sinus puncture is a common procedure for treating sinusitis.

    Purpose of the Study:

    • To assess the frequency of nasolacrimal duct ostium injury during maxillary puncture.
    • To investigate changes in the maxillary medial wall post-puncture.
    • To identify anatomical features of the ostiomeatal complex associated with chronic inflammation.

    Main Methods:

    • Endoscopic examination of 41 sinuses from 27 deceased middle-aged patients within 24 hours post-mortem.
    • Evaluation of anatomical variations in the ostiomeatal complex.
    • Assessment of nasolacrimal duct ostium integrity after simulated puncture.

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    Main Results:

    • One-third of the population studied exhibited chronic maxillary inflammation due to ostiomeatal complex anomalies.
    • Severe trauma to the nasolacrimal duct ostium occurred in approximately 50% of simulated punctures.
    • Natural sinus anastomosis dysfunction was observed in about 20% of cases, with accessory anastomosis in 12.2%.

    Conclusions:

    • Maxillary puncture carries a significant risk of nasolacrimal duct ostium injury, particularly in patients with anatomical variations.
    • The findings suggest a need for more cautious consideration of indications for maxillary puncture in cases of chronic maxillary sinusitis with ostiomeatal complex alterations or blocked natural anastomosis.