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Endoscopy In Chronic Maxillary Sinusitis Proves Reliable

An endoscopic approach to chronic maxillary sinusitis of dental origin is a new and reliable technique. It is associated with less morbidity and fewer complications, say specialists.

The researchers from in Moscow and Novosibirsk, Russia, reported an overall recovery rate after primary surgery of 94.7 percent.

To evaluate a minimally invasive endoscopic shaver-assisted technique for treating chronic maxillary sinusitis of dental origin. the specialists conducted a retrospective multi-centre chart review at two clinics of 70 patients aged 16 to 62 years diagnosed with the condition and treated with the technique.

Data were analysed from two main groups - patients with and without chronic oral antral fistula.

Of the 70 patients, 39 presented with oral antral fistula of different locations, the most common being third molar fistula (n=26). Foreign bodies were found in 21 sinuses (11 teeth roots, seven dental fillings and three packs). Fungal ball was found in six sinuses.

The surgical technique included retrograde resection of the uncinate process, enlargement of the natural maxillary ostium posteriorly and removal of the polyps and foreign bodies from the sinus through the middle meatal antrostomy window. Approach through the oral antral fistula facilitated additional access to the alveolar recess.

Polyps were removed from the alveolar recess using the microdebrider, which was introduced through the fistula under endoscopic control through the nasoantral window. The fistula was closed in two layers.

The results were good results in all but four patients for up to three years without any complications.
The Laryngoscope 2002;112:1056-1059. "Chronic Maxillary Sinusitis of Dental Origin: Is External Surgical Approach Mandatory?"

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