Intra-operative evaluation of natural ostia of the maxillary sinuses in children with chronic rhinosinusitis
Journal Title: New Medicine - Year 2010, Vol 14, Issue 4
Abstract
Introduction. Narrowing of the natural ostium of the sinuses is stated in the literature to be the main structural cause of chronic rhinosinusitis. Thanks to computed tomography (CT), we are able to confirm rhinosinusitis as well as to make a prognosis of its progression. CT also enables evaluation of the state of the natural ostia and any pathological lesions that may lead to chronic inflammation. The majority of authors make a diagnosis and evaluate the progression of the disease on the basis of computed tomography or magnetic resonance imaging. The need for endoscopy of the nasal cavities, with evaluation of natural ostia in the middle nasal duct, is also emphasised. Patients with chronic rhinosinusitis caused by narrowing of the natural ostia should be qualified for surgical treatment. Currently available paediatric endoscopic sinus surgery (PESS) is based on modifications of operations by Vigand or Stammberger.Aim. The aim of this study was to analyse lesions that may influence the functioning of the paranasal sinuses, and the intra-operative image of the natural ostium, from both the nasal cavity and the lumen of the maxillary sinus, in a group of children operated on as a result of chronic rhinosinusitis.Material and method. In the study, the intra-operative image of the natural ostia of the maxillary sinuses of children operated on for chronic rhinosinusitis in the Department of Paediatric Otolaryngology of the Medical University of Warsaw, during the period from July 2008 to December 2009, was assessed.Results. Unilateral lesions of the natural ostia of the maxillary sinuses were found in 4 cases (3.84%) and bilateral lesions in 100 cases (96.15%). In total, 208 maxillary sinuses were evaluated. During evaluation of the ostia from the nasal cavity, normal ostia were found in 196 (94.23%) cases, inflammatory-oedematous lesions in 9 (4.32%) cases, and polyps in 3 (1.44%) cases. During evaluation of the ostia from the lumen of the maxillary sinuses, normal ostia were found in 4 (1.92%) cases, inflammatory-oedematous lesions in 191 (91.82%) cases, a diaphragm in the area of the ostium in 7 (3.36%) cases, and polyps in 6 (2.88%) cases.
Authors and Affiliations
Lechosław Chmielik, Jolanta Jadczyszyn, Magdalena Frąckiewicz, Mieczysław Chmielik
Keywords
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