Abstract
IntroductionChronic rhinosinusitis with nasal polyposis is a common chronic disease that often affects maxillary sinus. Endoscopic sinus surgery is the most common procedure for treating the majority of maxillary sinus lesions. ObjectiveTo demonstrate the role of canine fossa puncture during endoscopic sinus surgery procedure in patients with severe maxillary sinus disease. MethodsWe present 2 cases where canine fossa puncture has been performed as method to obtain a complete access to the maxillary antrum. ResultsAccording our experience, 2 cases on 296 endoscopic sinus surgery (0.6%) where antrostomy and used of angled microdebrider were not sufficient, canine fossa puncture has been performed as an alternative method to obtain a complete access to the maxillary antrum. ConclusionAlthough the advent of endoscopic sinus surgery, our cases support the fact that actually canine fossa puncture is a minimally invasive technique useful in selected cases.
Highlights
Chronic rhinosinusitis (CRS) with nasal polyposis (NP) is a common chronic disease that seriously affects the quality of life.[1]
The majority of maxillary sinus lesions can be removed through the widened natural ostium performing partial uncinectomy and middle meatal antrostomy (MMA), some patients have extensive disease that is difficult to handle purely endoscopically
No benefit of the canine fossa procedure over conventional middle meatal antrostomy was seen after months follow up, series are small in both groups (11 Canine fossa puncture (CFP) vs. MMA)
Summary
Chronic rhinosinusitis (CRS) with nasal polyposis (NP) is a common chronic disease that seriously affects the quality of life.[1] Obliteration of the ostiomeatal unit is the most common factor influencing the pathogenesis of this inflammatory process.[2] Endoscopic sinus surgery (ESS) is the most common procedure for treating CRS that is refractory to medical treatment. The majority of maxillary sinus lesions can be removed through the widened natural ostium performing partial uncinectomy and middle meatal antrostomy (MMA), some patients have extensive disease that is difficult to handle purely endoscopically. Endoscopic access by natural ostium only allow to clear the posterior lateral wall, the posterior region of the roof, and the posterior wall of the maxillary sinus but no anterior and inferior regions. Failure to remove massive polyposis and fungal debris from the maxillary sinus may result in an early postoperative recurrence of symptoms and disease for the patient.[3]
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