Treatment Of Maxillary Sinus Disease Through Windowing Middle Meatus Maxillary Sinus And The Frontal Recess Of Tears

Objective To study the clinical efficacy of in the nasal endoscopicwindowing middle meatus maxillary sinus, associated with frontal recess oftears approach to treatment of maxillary sinus disease.Methods The Ent&HN surgery department of our hospital fromJanuary2010to March2011,22cases of maxillary sinus disease of patientswith patients with clinical observation and postoperative follow-up,follow-up data of22cases, including18males and4females,age14-61years, the average (37±14.50)years of age.Under the guidance ofendoscopic，windowing of middle meatus maxillary sinus associated withfrontal recess of tears approach to treatment of maxillary sinus disease. Allpatients were maxillary sinus benign lesions，including three cases ofrecurrent maxillary sinusitis associated with polyps，fungal maxillarysinusitis in five cases，twelve cases of maxillary sinus cyst，two cases ofhemorrhagic and necrotic polyps. Recurrent maxillary sinusitis with polypspatients have a history of operation in2cases, two in1cases withoperation history.Frontal recess of tears approach anatomy or anatomical nasolacrimal duct. All patients were also windowing of inferior nasalmeatus，at the same time,according to the lesions to decide whether toremove maxillary sinus before the next wall bone. Assessment of operativetime, hospital stay, the monitoring of postoperative complications, theresults of the data for statistical analysis, and evaluation of two surgicalway of treatment.Results22cases of operation time in patients with recurrent sinusitis andpolyps with an average of1.2hour, average1hour of maxillary sinus cyst,hemorrhagic and necrotic polyps with an average of1hour, average1hourof fungal maxillary sinusitis.22cases of the average of operation time inpatients is （1.03±0.07） hour and the average of length of stay is（6.36±0.49）day.The treatment of windowing middle meatus maxillarysinus, associate with frontal recess of tears exposed the maxillary sinuscavity completely. Followed up of6months to1year，the average8.73months of time.The surgical cavity recovered well to the patients withmaxillary sinus cyst and hemorrhagic and necrotic polyps; Cases ofrecurrent chronic maxillary sinusitis with polyps, the local mucosal of thesurgical cavity was cystic bubbly uplift; Fungal maxillary sinusitis sinusmucosal edema, given to dressing and nasal irrigation, graduallyepithelialization of the wound mucosa of the maxillary sinus cavity. Nocase occurred membranous nasolacrimal duct injury,headache, nasal mucosa atrophy,dry incidence as well as cheek numbness and othercomplications. All incisions healed l properly, inferior turbinate wasmorphologically normal, no local necrosis, windowing of inferior nasalmeatus unobstructed drainage.Conclusions The approach of windowing middle meatus maxillary sinusassociated with frontal recess of tears to treatment of maxillary sinusdisease in the nasal endoscopic was wide field and no dead ends, moreover,clear the lesions completely. Provides a clear window for the follow-uptreatment of the maxillary sinus cavity and dressing in nasal endoscopic.This method protects the morphology of the inferior turbinate, nasolacrimalduct inferior turbinate flap without injury, retained the structure andfunction of the anatomy of the lateral nasal wall. Avoid the headache, nasalmucosa atrophy and dry incidence of complications. This method istrauma and clinical outcome，provides a new way for the treatment ofmaxillary sinus benign.