Department ENT, King Fahd Central Hospital in Jazan, Saudi Arabia.
Department Otolaryngology, King Saud University College of Medicine, Saudi Arabia.
Ear Nose Throat J. 2024 Nov;103(11):NP657-NP661. doi: 10.1177/01455613221081567. Epub 2022 Feb 27.
Nasal irrigation is among the most widely used treatment modalities for sinonasal diseases. The extent of irrigation is well studied in operated sinuses but not for non-operated sinuses. Moreover, the preferred head positioning during irrigation is not known. Herein, we studied the extent of nasal irrigation in cadaveric heads with non-operated sinuses.
Nine cadaveric heads were used. Normal saline solution mixed with radiological contrast material was used to irrigate the nasal cavities with the heads in 2 different positions: standing-leaning-forward (SLF) and Head-down forward (HDF). After each irrigation, computed tomography images of the head were acquired. The extent of irrigation was assessed for each subunit of the sinonasal cavity.
Irrigation was performed twice on a total of 18 sides, each time in 1 position. Nine subunits were evaluated: inferior, middle, and superior meati; the olfactory cleft; and the frontal, maxillary, anterior, and posterior ethmoid and sphenoid sinuses. The extent of irrigation was significantly better in the HDF position for the olfactory cleft (100% vs 33%), -value=.001, frontal sinus (33% vs 11%), -value=.002, maxillary sinus (78% vs 17%), -value=.001, and anterior ethmoid sinus (89% vs 17%), -value=.001. There was no significant difference in the extent of irrigation between the 2 positions for the other evaluated subunits. The overall extent of irrigation was 70.37% of the subunits in HDF position and 45.06% of the subunits for SLF position, -value= .001.
Nasal irrigation reached the cavities of non-operated paranasal sinuses. However, while the extent of irrigation was limited in the SLF, it was well achieved in the HDF position. Studies on the clinical efficacy of irrigation in this position are recommended.
鼻腔冲洗是治疗鼻-鼻窦疾病最广泛使用的治疗方法之一。在已手术的鼻窦中，冲洗的范围研究得很充分，但在未手术的鼻窦中则不然。此外，目前尚不清楚冲洗时首选的头部位置。在此，我们研究了未手术鼻窦的尸体头部中的鼻腔冲洗范围。
使用生理盐水溶液混合放射性造影剂，将尸体头部置于两种不同位置进行鼻腔冲洗：站立前倾（SLF）和头前倾（HDF）。每次冲洗后，对头部进行计算机断层扫描。评估每个鼻-鼻窦亚单位的冲洗范围。
总共对 18 侧进行了 2 次冲洗，每次均在 1 个位置。评估了 9 个亚单位：下、中、上鼻道；嗅裂；额窦、上颌窦、前筛窦、后筛窦和蝶窦。在 HDF 位置，嗅裂（100%比 33%，-值=0.001）、额窦（33%比 11%，-值=0.002）、上颌窦（78%比 17%，-值=0.001）和前筛窦（89%比 17%，-值=0.001）的冲洗范围明显更好。在其他评估的亚单位中，2 个位置的冲洗范围没有显著差异。HDF 位置的冲洗范围总体为亚单位的 70.37%，SLF 位置为 45.06%，-值=0.001。
鼻腔冲洗到达了未手术的副鼻窦腔。然而，在 SLF 位置冲洗范围有限，而在 HDF 位置冲洗范围良好。建议进行该位置冲洗临床疗效的研究。
