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Sinusitis in the nasotracheally intubated patient
B E Linden1, E A Aguilar, S J Allen
1Department of Otolaryngology-Head and Neck Surgery, Health Science Center, Houston 77030.
Archives of Otolaryngology--Head & Neck Surgery
|August 1, 1988
Summary
Diagnosing and treating maxillary sinusitis in nasotracheally intubated patients requires an aggressive approach. Maxillary sinus aspiration and lavage are crucial for effective diagnosis and treatment of this complication.
Area of Science:
- Medical Complications
- Intensive Care Medicine
- Otolaryngology
Background:
- Maxillary sinusitis is a recognized complication of nasotracheal intubation.
- This condition presents diagnostic and therapeutic challenges in intensive care settings.
Purpose of the Study:
- To define diagnostic and therapeutic strategies for maxillary sinusitis in nasotracheally intubated patients.
- To evaluate an aggressive diagnostic and treatment protocol.
Main Methods:
- Prospective study of 19 patients in a surgical intensive care unit over six months.
- Diagnostic criteria included fever, leukocytosis, purulent rhinorrhea, and sinus opacification on roentgenograms.
- Treatment involved oral endotracheal tube replacement, maxillary sinus aspiration and lavage, and targeted antibiotic therapy.
Main Results:
- 19 cases of maxillary sinusitis were identified.
- All patients underwent sinus aspiration and lavage; 16 were on antibiotics prior to diagnosis.
- Four patients required repeat lavage, but all achieved resolution of sinus disease.
Conclusions:
- An aggressive diagnostic and treatment strategy is necessary for sinusitis in nasotracheally intubated patients.
- Maxillary sinus aspiration and lavage should be integral to the management of these patients.