Shcherbakov D A, Krotova A S, Aleksanyan T A
All-Russian Center for Eye and Plastic Surgery of the Ministry of Health of Russia, Ufa, Russia.
Neftyanik Hospital, Tyumen, Russia.
Vestn Otorinolaringol. 2020;85(2):37-40. doi: 10.17116/otorino20208502137.
Pathological ventilation of the maxillary sinus (MS) is one of the risk factors for the formation of chronic maxillary sinusitis.
Is to evaluate the effectiveness of the method of restoring the medial wall of the MS with an autograft - a quadrangular cartilage of the nasal septum using the butterfly technique (Patent Application No. 2018140468, priority of 11/19/2018).
The study included patients who underwent septoplasty, endoscopic surgery on the MS with plasty of the medial wall of the MS (1st, main group, =136), as well as patients who underwent surgery according to Caldwell-Luc with the formation of persistent nasoantral anastomosis in the lower nasal passage (2nd, control group, =56). The criteria for the inclusion of patients in the study were as follows: the presence of MS fungal body; inverted papilloma with lesions of the MS; cysts and/or a foreign body of the MS with localization in the alveolar bay without involving the natural anastomosis in the pathological process; concomitant 3rd or 4th, or 5th or 6th types of curvature of the nasal septum according to R. Mladina (1987). An objective assessment of the condition of the patients was carried out using the SNOT-22 clinical questionnaire, and for analysis the state of aerodynamics of the nasal cavity and MS in patients of various groups after surgical treatment used the method of computational aerodynamics.
In patients with nasoantral ostium in the lower nasal meatus, the pathological maxillary sinus aeration one was observed. It is recommended to close the nasoantral ostium to prevent violations of the aerodynamics of the nasal cavity and the maxillary sinus during surgery through the lower nasal meatus.
Our proposed method for closing a defect in the lower nasal passage is effective. The autograft is well established, contributes to the speedy restoration of normal sinus aerodynamics.
上颌窦（MS）的病理性通气是慢性上颌窦炎形成的危险因素之一。
评估使用蝶形技术（专利申请号2018140468，2018年11月19日优先权）用自体移植物——鼻中隔四角软骨修复MS内侧壁方法的有效性。
研究纳入接受鼻中隔成形术、MS内镜手术并对MS内侧壁进行整形的患者（第一组，主要组，n = 136），以及接受考德威尔-卢氏手术并在下鼻道形成持续性鼻窦吻合口的患者（第二组，对照组，n = 56）。纳入研究患者的标准如下：存在MS真菌体；伴有MS病变的内翻性乳头状瘤；MS囊肿和/或异物，位于牙槽窝且病理过程未累及自然吻合口；伴有R. Mladina（1987）分类的鼻中隔第三或第四或第五或第六种类型弯曲。使用SNOT - 22临床问卷对患者状况进行客观评估，手术治疗后，采用计算空气动力学方法分析不同组患者鼻腔和MS的空气动力学状态。
在下鼻道有鼻窦口的患者中，观察到病理性上颌窦通气情况。建议关闭鼻窦口，以防止手术过程中通过下鼻道侵犯鼻腔和上颌窦的空气动力学。
我们提出的关闭下鼻道缺损的方法是有效的。自体移植物植入良好，有助于快速恢复正常鼻窦空气动力学。
