Persistent sinusitis from recirculating mucus after inferior turbinectomy

Abstract

Recirculation of mucus between adjacent openings into the maxillary antrum is a relatively common cause of persistent sinusitis in either the pre- or postsurgical patient.It is particularly prone to occur if intranasal sinus surgery is performed without the use of angled telescopes. In this situation, the natural ostium is often out of direct vision, and an antrostomy is created in the posterior fontanelle separate from the natural ostium, thus setting the scene for recirculation of mucus with resultant persistent infection.The phenomenon also occurs commonly between a middle meatal opening and an inferior meatal antrostomy usually created at a prior operation, if the inferior turbinate has been significantly excised. The presence of an intact inferior turbinate usually acts as a deflecting baffle to prevent the recirculation process.Recirculation may also be relevant for persistent sinusitis in the sphenoid and frontal sinuses.