Evaluation of Recurrent Maxillary Sinusitis due to Middle Meatal Antrostomy Site Stenosis
- Authors
- Kim, Hyo Jun; Choi, Ji Ho; Lee, Jae Yong
- Issue Date
- Oct-2020
- Publisher
- Annals Publishing Co.
- Keywords
- middle meatal antrostomy; stenosis; recurrent; maxillary sinusitis; inflammation; granulation
- Citation
- Annals of Otology, Rhinology and Laryngology, v.129, no.10, pp 964 - 968
- Pages
- 5
- Journal Title
- Annals of Otology, Rhinology and Laryngology
- Volume
- 129
- Number
- 10
- Start Page
- 964
- End Page
- 968
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/2457
- DOI
- 10.1177/0003489420929365
- ISSN
- 0003-4894
1943-572X
- Abstract
- Objective: This study was performed to evaluate the incidence, timing, and factors contributing to recurrent maxillary sinusitis due to middle meatal antrostomy (MMA) site stenosis after endoscopic sinus surgery (ESS). Methods: The medical records and endoscopic photographs of 288 patients with chronic rhinosinusitis who underwent ESS were evaluated. Patients visited the clinic with similar schedule after ESS; recurrent maxillary sinusitis due to MMA site stenosis was investigated, including in terms of the incidence and timing. The preoperative computed tomography (CT) scans, intraoperative findings, and possible factors contributing to MMA site stenosis were examined. Results: Recurrent maxillary sinusitis due to MMA site stenosis occurred in 10 patients. Most had unilateral sinusitis and stenosis was observed within 6 months postoperatively. All patients had severe inflammation, pus retention, and thick mucosal hypertrophy in the maxillary sinus on preoperative CT; intraoperative findings confirmed these conditions. In most patients, extensive trimming of the hypertrophied mucosa was performed intraoperatively through canine fossa trephination. Conclusions: MMA site stenosis is a rare condition after ESS. We hypothesized that rapid shrinkage and fibrosis of the sinus mucosa after extensive trimming thereof may be the main causes of stenosis. Residual mucosal inflammation, granulation formation, and persistent sinus crust and debris may also be contributing factors. Therefore, conservative trimming, meticulous dressing, and removal of sinus crust and granulation tissue near the MMA site should be performed in patients with MMA site stenosis.
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Collections - College of Medicine > Department of Otorhinolaryngology > 1. Journal Articles
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