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Endoscopic Visualization of the True Maxillary Ostium Following Uncinectomy
Omar H Ahmed1, Marissa P Lafer1, Ilana Bandler2
1Department of Otolaryngology-Head and Neck Surgery, New York University, New York, NY, USA.
Ear, Nose, & Throat Journal
|May 25, 2019
Summary
Angled endoscopes are frequently needed for visualizing the true maxillary ostium during endoscopic sinus surgery. A smaller sphenoid keel-caudal septum-nasolacrimal duct angle on CT scans may predict this need.
Area of Science:
- Otolaryngology
- Endoscopic Sinus Surgery
- Anatomy
Background:
- Accurate visualization of the true maxillary ostium (TMO) is crucial during endoscopic sinus surgery (ESS).
- Failure to visualize the TMO can lead to complications like iatrogenic recirculation.
Purpose of the Study:
- To determine the frequency of angled endoscope use for TMO visualization post-uncinectomy and pre-maxillary antrostomy.
- To identify preoperative computed tomography (CT) predictors for the need of an angled endoscope.
Main Methods:
- Retrospective study of 63 maxillary antrostomies from primary ESS for chronic rhinosinusitis.
- Analysis of preoperative CT scans for anatomical measurements.
- Correlation of CT findings with intraoperative endoscope use.
Main Results:
- An angled endoscope was required in 55.6% of cases to visualize the TMO.
- A smaller sphenoid keel-caudal septum-nasolacrimal duct (SK-CS-NL) angle on CT was significantly associated with the need for an angled endoscope (P = .010).
Conclusions:
- Angled endoscopes are commonly necessary for TMO visualization during maxillary antrostomy.
- Preoperative CT measurement of the SK-CS-NL angle may help identify patients requiring angled scopes, aiding surgical planning and preventing complications.
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