Endoscopic versus Caldwell-Luc approach in chronic maxillary sinusitis: comparison of symptoms at one-year follow-up.

The aim of this prospective randomized study was to compare functional endoscopic sinus surgery (FESS) with the standard Caldwell-Luc (C-L) procedure in relieving the symptoms of chronic maxillary sinusitis. One hundred and fifty consecutive adult patients were operated after the failure of treatment with antimicrobials and repeated antral irrigations: 143 patients were available for the follow-up examination, at a median of 12 months after the operation. The patients' global evaluation showed marked improvement in 50.7% of the C-L group and in 76.7% of the FESS group. Overall subjective symptoms deteriorated in 5.5% of C-L operated patients, but not at all in the FESS group. Patients' compliance, asked post-operatively, was 80.2% in C-L patients and 93.0% in FESS patients.

Orientation of human respiratory cilia.

Ciliary orientation was studied on the respiratory epithelium of the nasal cavity or the sphenoidal sinus of ten adult nonsmokers without respiratory disease. The ciliary orientation was evaluated from micrographs by measuring the angle between the plane defined by the central tubules and reference line (with a semiautomatic image analyser (IBAS I]. The standard deviation of the angles of cilia population was counted in every field. The standard deviation of the measurements described the ciliary alignment. It varied from 12.1-41.2 degrees. The mean standard deviation was 27.3 +/- 7.4 degrees. 58% of all measured cilia were within +/- 0-20 degrees of the mean and 85% of cilia were within +/- degrees. However, a few cilia or small groups of cilia were found in most fields which differed dramatically from the main orientation. The size of these groups was always less than ten cilia. On the normal respiratory epithelium the standard deviation of ciliary orientation varies between +/- 10-40 degrees (at about 97% probability). For diagnostic conclusions more than 60 cilia should be measured.