The strategy of the of surgical treatment of the cysts in the maxillary sinus

Abstract

Based on the results of the retrospective analysis of 12 094 medical histories available from five large otorhinolaryngological clinics of the city of Moscow the authors arrived at the conclusion that the surgical treatment of maxillary sinus patholologies including the resection of retentional cysts accounts for 4.1% of the total number of surgical interventions on the ENT organs. The endonasal and extranasal approaches were used in 28.5% and 68.9% of the cases respectively. The combined approach to the maxillary sinus was applied in 2.6% of all the cases. The vector studies of the anatomical features of the ostiomeatal complex in 102 patients presenting with cystic lesions of the maxillary sinus with the use of computed tomography have demonstrated that the lumen of the complicated system communicating the maxillary sinus and the nasal cavity remains patent along its entire length; its part in the ethmoidal infundibulum region is as long as 1.31±0.03 mm and amounts to 2.09±0.02 mm in the region of natural anastomosis of the maxillary sinus (p<0,01). The results of the histological study of 81 histological preparations give evidence that the lesions of the mucous membrane in the regions of ethmoidal infundibulum and natural anastomosis of the maxillary sinus have a chronic character and manifest themselves as sclerosis of lamina propria and hyperplasia of mucous glands. The authors nave come to the conclusion that the surgical approach to the maxillary sinus through the middle meatus is not sufficiently well substantiated and therefore can not be recommended for the resection of the cysts from this air cavity in the body of the maxilla.