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Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Reevaluation of maxillary sinus surgery: experimental study in rabbits
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD.
The Annals of Otology, Rhinology, and Laryngology
|November 1, 1989
Summary
Surgical widening of sinus ostia may impair mucociliary clearance and increase infection risk. While some clearance can recover, it is often imperfect, suggesting caution with these functional endoscopic sinus surgery techniques.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Sinus Physiology
Background:
- Functional endoscopic sinus surgery (FESS) often targets ostiomeatal complex disease.
- Maxillary sinus ostioplasty, widening the sinus ostium, is performed but contradicts established surgical principles.
Purpose of the Study:
- To reevaluate the effects of antrostomies and intrasinus mucosal removal on sinus function.
- To assess the impact of surgical ostium widening on mucociliary clearance and infection rates.
Main Methods:
- Thirty rabbits underwent procedures: widening the natural ostium, creating a separate antrostomy, or radical mucosal removal.
- Fifteen sinuses served as controls.
- Sinus mucosa and mucociliary clearance were evaluated after 6-8 weeks.
Main Results:
- Mucociliary clearance persisted towards the natural ostium after inferior antrostomy.
- Clearance through the widened ostium redeveloped in 11/18 sinuses but was imperfect.
- No ostial closure occurred, but infection rates significantly increased in all experimental groups compared to controls.
Conclusions:
- Surgical widening of the natural sinus ostium can lead to imperfect mucociliary clearance.
- Antrostomies and intrasinus mucosal removal increase the risk of sinus infection.
- These findings question the routine practice of surgically widening sinus ostia in FESS.
