González PGCA, Morales CGM

Language: Spanish
References: 20
Page: 134-140
PDF size: 367.13 Kb.

ABSTRACT

Background: The main cause of failures in the functional endoscopic sinus surgery (FESS), according to reports found in literature, is the formation of symptomatic synechiae (adhesions) of the middle turbinate with the lateral sidewall of the nose causing a recurrence of the disease.
Objective: To compare the evolution and recurrence of the medialization of the middle turbinate with transeptoturbinal stitch and with no stitch, through nasal endoscopic surgery for surgical treatment of chronic rhinosinusitis.
Patients and method: A total of 60 patients were divided in 2 groups: A (with stitch) and B (without stitch). The patients of Group A had a transeptoturbinal suture with prolene 4-0 between the middle turbinate (uni or bilateral) and the septum. Group B, conventional FEES with no type of medialization technique of the middle turbinate. The patients of both groups were monitored during 3, 6 and 12 months after surgery.
Results: Group A: 22 patients, 1 synechiae and 3 (14%) recurrences. Group B: 36 patients, 5 synechiae and 7 (18%) recurrences. Among the patients who had a recurrence of the disease, it was not associated to synechiae (p = 0.1591).
Conclusions: As for the patients of the group A, it was managed to keep the middle meatus patent and facilitate the following check ups at the doctor’s office, having the adequate cleaning. The recurrence rate is slightly lower in the group A, however it is not statistically significant.

REFERENCES

1. Ramadan HH. Surgical causes of failure in endoscopic sinus surgery. Laryngoscope 1999;109(1):27-29.

2. Thornton RS. Middle turbinate stabilization technique in endoscopic sinus surgery. Arch Otolaryngol Head Neck Surg 1996;122(8):869-872.

3. Havas TE, Lowinger DS. Comparison of functional endonasal sinus surgery with and without partial middle turbinate resection. Ann Otol Rhinol Laryngol 2000;109(7):634-640.

4. Gall RM, Witterick IJ. The use of middle meatal stents post-endoscopic sinus surgery. J Otolaryngol 2004;33(1):47-49.

5. Stewart MG. Middle turbinate resection. Arch Otolaryngol Head Neck Surg 1998;124(1):104-106.

6. Fortune S, Duncavage JA. Incidence of frontal sinusitis following partial middle turbinectomy. Ann Otol Rhinol Laryngol 1998;107:447-453.

7. Houser SM. Empty nose syndrome associated with middle turbinate resection. Otolaryngol Head Neck Surg 2006;135(6):972-973.

8. Shih C, Chin G, Rice DH. Middle turbinate resection: impact on outcomes in endoscopic sinus surgery. Ear Nose Throat J 2003;82(10):796-797.

9. Friedman M, Schalch P. Middle turbinate medialization with bovine serum albumin tissue adhesive (BioGlue). Laryngoscope 2008;118(2):335-338.

10. Weitzel EK, Wormald PJ. A scientific review of middle meatal packing/stents. Am J Rhinol 2008;22:302-307.

11. Kim JH, Lee J, Yoon J, Chang JH. Antiadhesive effect of the mixed solution of sodium hyaluronate and sodium carboxymethylcellulose after endoscopic sinus surgery. Am J Rhinol 2007;21:95-99.

12. Lee JY, Lee SW. Preventing lateral synechia formation after endoscopic sinus surgery with a silastic sheet. Arch Otolaryngol Head Neck Surg 2007;133(8):776-779.

13. Yanagisawwa E, Joe JK. The use of spacers to prevent postoperative middle meatal adhesions. Ear Nose Throat J 1999;108:530-532.

14. Shrime MG, Tabaee A, Hsu AK, Rickert S, Close LG. Synechia formation after endoscopic sinus surgery and middle turbinate medialization with and without Flo- Seal. Am J Rhinol 2007;21(2):174-179.

15. Hockstein NG, Bales CB, Palmer JN. Transseptal suture to secure middle meatal spacers. Ear Nose Throat J 2006;85(1):47-48.

16. Bolger WE, Kuhn FA, Kennedy DW. Middle turbinate stabilization after functional endoscopic sinus surgery: the controlled synechiae technique. Laryngoscope 1999;109(11):1852-1853.

17. Friedman M, Landsberg R, Tanyeri H. Middle turbinate medialization and preservation in endoscopic sinus surgery. Otolaryngol Head Neck Surg 2000;123(1 Pt1):76-80.

18. Friedman M, Tanyeri H, Landsberg R, Caldarelli D. Effects of middle turbinate medialization on olfaction. Laryngoscope 1999;109(1):27-29.

19. Moukarzel N, Nehme A, Mansour S, Yammine FG, Moukheiber A. Middle turbinate medialization technique in functional endoscopic sinus surgery. J Otolaryngol 2000;29(3):144-147.

20. García CY, Nurko B, Martínez RR, Zurita KC y col. ¿Sutura?: Nueva técnica de medialización del cornete medio en cirugía endoscópica de mínima invasión. Anales Médicos ABC 2000;45(3):113-115.