Centre Hospitalier de Versailles, Service d'ORL et chirurgie cervico-faciale, Le Chesnay, France.
Ear Nose Throat J. 2023 Apr;102(4):239-243. doi: 10.1177/0145561320983942. Epub 2021 Feb 27.
Nasal saline irrigation is the corner stone of postoperative care after functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis (CRS). However, intrasinus penetration of the saline solution can be challenging and may require difficult head position, particularly for the frontal sinus. Our aim was to evaluate a novel device for direct intrasinus self-irrigation, usable at home for both maxillary and frontal sinus.
Thirty devices were implemented in 23 patients: in the maxillary sinus for 18 patients and in the frontal sinus for 5 patients. The device was removed after 7 days on average (5-10 days), and nasal saline irrigation was carried on with a squeeze bottle for 6 weeks. Retrospective evaluation of the device included: device-related complication, patient satisfaction, and ostial or middle turbinate synechiae at 3 months.
No device-related complication (obstruction, displacement, infection, bleeding) occurred. Twenty-one (91.3%) patients were satisfied with the device. Two patients required the help of a nurse for irrigation. No ostial of middle turbinate synechiae was visualized at 3 months. This new endonasal device enables direct intrasinus self-irrigation after FESS for CRS.
This preliminary study showed that this device is safe and easy to use. However, further investigations are required to assess its potential role to reduce the risk of synechiae and revision surgery.
鼻腔盐水冲洗是慢性鼻-鼻窦炎(CRS)患者功能性内镜鼻窦手术后(FESS)术后护理的基石。然而,盐水溶液向窦内渗透可能具有挑战性,并且可能需要患者采取困难的头部位置,尤其是在额窦。我们的目的是评估一种新型的用于直接向窦内自我冲洗的设备,可用于上颌窦和额窦,患者可在家中使用。
在 23 例患者中实施了 30 个装置:18 例患者用于上颌窦,5 例患者用于额窦。该装置平均在 7 天(5-10 天)后被取出,然后使用挤压瓶进行为期 6 周的鼻腔盐水冲洗。对该设备的回顾性评估包括:与设备相关的并发症、患者满意度以及 3 个月时的窦口或中鼻甲黏连。
无设备相关并发症(阻塞、移位、感染、出血)发生。21 例(91.3%)患者对该设备满意。有 2 例患者需要护士协助进行冲洗。3 个月时未见窦口或中鼻甲黏连。这种新型的经鼻内装置可在 FESS 治疗 CRS 后进行直接向窦内自我冲洗。
这项初步研究表明,该设备安全且易于使用。然而,需要进一步的研究来评估其减少黏连和翻修手术风险的潜在作用。