Endoscopic maxillary sinusotomy - what is it? The course of the operation and the consequences

In the early stages of sinusitis, drug therapy is effective. If the flow is running, when the discharge from the nasal cavity becomes not mucous, but purulent, it is possible to escape by puncturing the sinuses. After that they are washed from the contents. Requires surgical intervention for prolonged inflammation of the maxillary sinuses. Symptoms, the treatment of which is long and ineffective, require a more serious solution to the problem. Here an operation is needed, and one of the forms of the surgical approach is endoscopic sinus anatomy.

What is it?

The maxillary sinuses are called cavities in the areas of the upper jaw on both sides of it. Because of the uncomfortable location, they are often exposed to inflammatory processes that often end in a chronic course and require surgical intervention. In the early stages, it is still possible to treat the pathology of the maxillary sinuses with medicamental methods. In the absence of efficacy or frequent relapses, the possibility of performing a maxillary sinusotomy for a particular patient should be considered. It is best to direct the patient to an endoscopic intervention that will be less invasive and maximally effective. Purulent maxillary sinusitis is a direct indication for treatment, because every minute is fraught with the formation of complications.

Questions about what the genyantotomy is intended for, what it is, are asked by many patients. During the operation, the maxillary sinuses are opened and all liquid contents are removed. With serious problems, surgical treatment is the only way out of the situation. Patients are sent to it, the inflammatory focus in which it is impossible to clean medicamentously. Therefore, access through the incision or puncture is required. Finding out when the maxillary sinus is performed, what it is, the patient is not so simple.

Indications for operation

Opening of maxillary sinuses is not advisable for every patient with inflammation. It is assigned:

1) with a cyst in the upper jaw;

2) chronic course of polypous maxillary sinusitis;

3) odontogenic maxillary sinusitis;

4) lack of results after long-term drug treatment and puncture;

5) frequent recurrences of maxillary sinusitis;

6) ingress of foreign bodies into the sinuses;

7) frequent or periodic painful sensations on the face, in the infraorbital region;

8) the periodic occurrence of nasal congestion without apparent cause (allergic reaction, colds);

9) the appearance of an unpleasant odor from the nose, which is felt by the patient himself or noted by the surrounding people;

10) periodic or constant sensation of pain of varying intensity in the area of the upper teeth;

11) sensation of the passage of air or fluid flows through the place where the tooth was previously removed;

12) the appearance of a filling material beyond the boundaries of the tooth being treated, which will be seen in the photograph when the radiograph is being taken;

13) the appearance on the computer tomogram of polyps or foreign bodies;

14) unsuccessful sinus lifting;

15) refusal to perform sinus lifting due to the detection of pathology in the maxillary sinus.

16) diagnosis of "purulent sinusitis."

In addition to the endoscopic method of intervention, there is also a classic operation of maxillary sinusitis. The most preferable is the first. It is less traumatic, and the duration of the procedure and recovery is shortened throughout the process.

Contraindications

In the presence of indications, limitations to surgical intervention are also taken into account. Endoscopic maxillary surgery is not performed in the following situations:

1) Exacerbation of chronic pathology of internal organs.

2) Manifestation of symptoms of sinusitis, but in many cases, surgery for this reason may not be postponed.

3) Diseases in the organs of severe severity, which can aggravate the course of the condition.

4) Violation of the blood coagulation system.

Many states of the body are considered relative. For a number of reasons, after agreement with the surgeon, the operation is not postponed for another period. Until this time, drug therapy is being performed to relieve the inflammation of the maxillary sinuses. Symptoms, the treatment of which is difficult to medicate oral medicine, are stopped by drugs administered intramuscularly until the day of the proposed operation.

Examination before a genyanthomia

After establishing the diagnosis and determining the need for surgical intervention, the patient is assigned the necessary studies. For this, laboratory and instrumental methods are used. The patient is referred for general blood tests, urine tests, biochemical tests, blood coagulation evaluation is performed. From the instrumental, images with CT and X-ray of the paranasal sinuses are required for the operation to assess their condition.

Endoscopic way of conduction of maxillary sinusitis

In comparison with the classical technology, the operation of endoscopic maxillary sinusotomy has several advantages:

• Absence of incisions at the site of the procedure, which is not accompanied by the appearance of scar tissue;
• Exclusion of a cosmetic defect;
• Reduction in the duration of the operation and the recovery period;
• Good tolerability of the procedure performed under local anesthesia;
• Short stay in hospital (up to 3-4 days);
• Almost imperceptible swelling at the site of the introduction of the instrument and its rapid disappearance;
• Almost complete absence of complications after surgery.

These advantages allow us to use modern methods for treating the pathology of the maxillary sinuses quickly and painlessly.

Preparing for an operation

On the day of the procedure you should not eat 6-7 hours before it. Such recommendations should be observed when preparing for local anesthesia. If a general anesthesia is planned, then in addition to the above it is forbidden to drink any drinks 2 hours before the operation.

Access with endometrial excision

With genyantritis having odontogenic origin, the only possible method is used unlike other conditions. Endoscopic maxillary sinusotomy is performed in all other situations by other accesses, depending on the indications for the operation. They include:

• The instrumentation through the middle or lower nasal passages;
• The introduction of an endoscope into the anterior wall of the maxillary sinus;
• Through the alveolus after tooth extraction (with odontogenic sinusitis);
• Through the hillock in the upper jaw.

When using the endoscopic technique of surgery, complications can be avoided, and choosing a specific site for access allows them to be reduced to minimum values.

Procedure

The operation is performed under local anesthesia. To introduce the solution, the advantage is given to needles with a diameter of no more than 0.2 mm. If necessary, general anesthesia is performed . Solutions with gaymorotomii have low toxicity and a long period of anesthesia. Its duration is not more than 30 minutes. The diameter of the endoscope inserted through the stroke is no more than 5 mm. Therefore, a puncture is performed in the area of the maxillary sinus minimal. Through it, the endoscope tube is installed and the pathologically changed tissues and liquid are removed. The whole process of the operation is performed under the control of the video registration transmitted to the monitor. This is necessary for easy examination of the cavity and its sanitation. After cleansing, wash the sinus with antiseptic solutions ("Furacilin", potassium permanganate).

Recovery period after surgery

The success of the procedure depends on the recovery of the patient after it. After discharge from the hospital, the surgeon gives a referral to the ENT doctor to monitor the condition. You need to visit it for at least a month, and, as necessary, the term can be extended. The doctor prescribes a course of antibiotics and solutions for washing the nasal cavity. Simultaneously, antihistamines and preparations are added to the scheme to strengthen the vascular wall in the presence of indications.

After a gammorotomy for a short period, a small edema remains. The "Cinnabsin" has a positive effect in this respect. It increases the body's own defenses and reduces swelling of the paranasal sinuses. Due to this, the recovery of the patient after surgery is accelerated.

Within a month should refuse to visit the pool, do not eat spicy, cold and hot food. It is necessary to avoid hypothermia and to take preventive measures to avoid getting influenza or ARVI. After 1-2 months it is advisable to visit the sanatorium or the course of salt caves for 10 days. The inspection necessary for the control of surgical treatment is carried out 6 months after the maxillary sinusitis and 1 year.

Consequences of endoscopic sinus

Like any surgical intervention, endoscopic maxillary sinusotomy can be complicated by conditions of varying severity. In contrast to the classical method of treatment, this operation rarely has unpleasant consequences. They manifest themselves in the early recovery period or late. Complications include:

1) Bleeding from the injection site of the instrument or site that has been exposed.

2) Nausea or vomiting, which is due to the ingress of blood into the stomach or the patient's individual response to the administration of anesthetic.

3) Severe pain in the nose.

4) Prolonged healing of the postoperative wound.

5) Damage to the branch of the trigeminal nerve, which leads to severe tenderness of the innervated area or numbness.

6) Formation of fistulous passages at the point of introduction of the instrumentation or incision.

7) Neuralgia associated with trauma during surgery.

8) Infection of the wound and its suppuration.

The incidence of complications is much less than the consequences arising from the absence of surgical treatment. In such cases, surgery is the only way out. Endoscopic maxillary sinusotomy is a modern technique that allows one to forget about sinusitis once and for all.

Memo for preparing patients for the procedure

After establishing the diagnosis and resolving the question of conduction of maxillary sinus anemia, it is important to tell the doctor about the intolerance of medicines. It is important to take into account individual reactions to a particular drug and to choose the best remedy for the patient in order to reduce the risk of possible consequences.

Reviews about the procedure

Endoscopic genyanthytoma reviews in most cases are positive. Patients report a rapid improvement in the quality of life, and most do not have complications. The only thing is the presence of a small swelling in the nose, which makes breathing more difficult. Symptom in a few days leaves without a trace.