RESUMEN
BACKGROUND AND OBJECTIVES: Among the postoperative complications of Caldwell-Luc operation, maxillary cysts are sometimes difficult to manage properly by conventional revision Caldwell-Luc procedure. However, with the advent of endoscopic procedures, the technique of intranasal fenestration operation through the inferior meatus has been improved. This study evaluate the surgical results of inferior meatal fenestration operation and examines the clinical indication of this technique. The authors also review surgical cases of postoperative maxillary cyst. MATERIALS AND METHOD: We reviewed 58 cases of postoperative maxillary cyst which were treated surgically in the last 10 years. We analyzed their chief complaints such as sex, age, duration between the initial surgery and the presentation of the symptoms, symptom relief after revision surgery, and the recurrence rate of each surgical techniques. Sites of the cyst in the maxillary sinus and the existence of the septa were analysed radiologically by using computed tomograms of paranasal sinuses. Fourty-eight cases received inferior meatal fenestration operation and 12 cases received revision Caldwell-Luc operation. RESULTS: Inferior meatal fenestration operation could be best indicated in the patients with bulging cysts in the inferior meatus. However, the non-bulging cysts which tare in contact with the inferior metus and those with the inferior metus and those with incomplete septa were also treated with the inferior meatal fenestration operation without recurrence. Comparing with the revision Caldwel-Luc procedure, the inferior meatal fenestration operation was less time consuming and provided less postoperative discomfort for the patients. Also, since the operation is carried out under the direct endoscopic control, fine procedures and the removal of septa in the cysts were possible. CONCLUSIONS: For inferior meatal fenesration operation, the need for a pre-operative endoscopic nasal examination and an evaluation of comography should be emphasized before selecting the suitable method of treatment. Inferior meatal fenestration operations appear to be the most suitable treatment for cases where cysts bulge into the inferior meatus.
Asunto(s)
Humanos , Seno Maxilar , Senos Paranasales , Complicaciones Posoperatorias , RecurrenciaRESUMEN
BACKGROUND: Transillumination of maxillary sinuses was an important method before the invention of X-rays. But as the more precise and valuable methods have been developed, its importance has been reduced in clinical practice. OBJECTIVES: To elucidate the vailidity of the transillumination in diagnosing the maxillary sinus diseases, the transillumination method was compared with the conventional PNS series. MATERIALS AND METHOD: We performed transillumination tests in 100 adults(48 males and 52 females). A fiberoptic cable with halogen light sorce was enough for the examination. The light detected in the face of examinee in the dark room was evaluated. We studied the clinical reliability of transillumination in representing the status of the maxillary sinus. RESULTS: For bilateral sinusitis group(N=48), transillumination matched with the conventinal PNS series in 64.6%(31/48) of the cases, unilateral sinusitis group(N=17) in 82.4%(14/17) and normal group(N=35) in 88.6%(30/35). The overall matched-rate was 75%(75/100). CONCLUSIONS: The transillumination is a helpful non-invasive mothod for clinical evaluation of the maxillary sinus conditions.
Asunto(s)
Humanos , Masculino , Invenciones , Seno Maxilar , Sinusitis , TransiluminaciónRESUMEN
BACKGROUND: In spite of frequent nasal surgery, the importance of preoperative medication has not been examined carefully(CAREFULLY). OBJECTIVE: To identify the effect of premedication, we investigated the effect of premedication on postoperative pain in nasal surgery under local anesthesia. MATERIALS AND METHOD: We studied 120 cases, composed of 60 cases of unilateral sinus surgery and 60 cases of septoplasty. The patients were divided into four groups. We analysed 4 groups each consisted of 30 patients(N=120). The first group consisted of patients who received atropine preoperatively. The second group received atropine and ketolorac tromethamine. The third group received atopine and diazepam. The fourth group received atropine, ketorolac trimethamine and atropine. To evaluate the postoperative pain, we made the protocol listed according to Verbal Rating Pain Scores(VRP), Visual Analogue Pain Scores(VAS), -2, 4, 6, 12, 24 and 48 hours- and a global postoperative pain using the VAS. RESULTS: In septoplasty group, pain-relief effects showed postoperative pain of ketorolac tromethamine during postoperative 6-hours in the second & fourth groups. In sinus surgery group, Ketorolac tromethamine was effective on postoperative pain at postoperative 2-hour. CONCLUSION: We concluded that preoperative ketorolac tromethamine was effctive on septoplasty group than sinus surgery group.