Significance of conservation of the horizontal bony strut of the basal lamellae in endoscopic sinus surgery / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the methods of maintaining the stability of middle turbinate (MT), reducing the incidence of middle meatus synechia formation and improving the treatment effect of endoscopic sinus surgery.</p><p><b>METHODS</b>A prospective study was conducted in 54 consecutive patients with chronic sinusitis. The patients were allocated into two groups. During the operation, the most anterior and superior MT attachments to the agger nasi region were preserved, and anterior and posterior ethmoidectomy were performed in group A (27 cases 47 sides). Besides above structures, the most posterior and inferior aspects of the basal lamellae and the horizontal boney strut structures of the basal lamellae were preserved in group B (27 cases 51 sides).</p><p><b>RESULTS</b>There were no significant differences between the two groups in age, course and preoperation visual analogue scale (VAS) score. The VAS scores in group A before and 1 year after operation were (6.41 +/- 0.25) and (1.70 +/- 0.36), the difference was significant (t = 10.472, P < 0.05). The VAS scores in group B before and 1 year after operation were (6.78 +/- 0.23) and (0.66 +/- 0.16), the difference was significant (t = 17.195, P < 0.05). The Lund-Kennedy scores in group A and group B one year after operation were (1.85 +/- 0.47) and (0.67 +/- 0.16), the difference was significant (t = 2.290, P < 0.05). The MT position was described as stable, slight drifting laterally and synechia formation. And the incidence of stable, slight drifting laterally and synechia between MT and the nasal lateral wall in group A and group B was 57.4%, 23.4%, 19.1% and 88.2%, 3.9%, 7.8% respectively, the differences were significant (chi(2) = 12.511, P < 0.05)</p><p><b>CONCLUSIONS</b>Conservation of the horizontal bony strut of basal lamellae could better maintain the stability of MT, reduce the incidence of MT drifting laterally and synechia formation, and finally improve the curative effect of endoscopic sinus surgery.</p>