Alromaih Saud, Aloraini Nouf, Alrasheed Abdulaziz, Alroqi Ahmad, Alsaleh Saad
Otolaryngology - Head and Neck Surgery, King Saud University, Riyadh, SAU.
Cureus. 2023 Feb 2;15(2):e34530. doi: 10.7759/cureus.34530. eCollection 2023 Feb.
Complete removal of maxillary sinus pathology can be challenging in specific locations. In the past, the Caldwell-Luc procedure was used for maxillary sinus disease. Currently, the endoscopic middle meatal antrostomy (EMMA) approach is used. However, it can often be difficult to reach certain locations of lesions by EMMA alone, requiring an endoscopic inferior meatal antrostomy (EIMA), which has been reported in the literature to have numerous complications. Furthermore, multiple techniques have been suggested for a combined bi-meatal approach to remove such lesions. We present a case of a 17-year-old with a challenging antrochoanal polyp (ACP) location requiring EIMA. The patient underwent our modified technique of submucosal inferior antrostomy with mucosal flap with no observed intra-operative and post-operative complications. Maxillary sinus pathology can be challenging due to limited access to specific regions. In this case report, we present a novel technique to achieve a temporary inferior antrostomy through a minimally invasive approach with a promising post-operative course.
在特定位置完全清除上颌窦病变可能具有挑战性。过去，柯-陆氏手术用于治疗上颌窦疾病。目前，采用内镜中鼻道上颌窦造瘘术（EMMA）。然而，仅通过EMMA往往难以到达病变的某些位置，这就需要内镜下下鼻道上颌窦造瘘术（EIMA），而文献报道EIMA有许多并发症。此外，已经提出了多种技术用于联合双鼻道方法来清除此类病变。我们报告一例17岁患者，其鼻窦后鼻孔息肉（ACP）位置具有挑战性，需要进行EIMA。患者接受了我们改良的带黏膜瓣的黏膜下下鼻道造瘘术，术中及术后均未观察到并发症。由于进入特定区域的途径有限，上颌窦病变可能具有挑战性。在本病例报告中，我们展示了一种通过微创方法实现临时下鼻道造瘘的新技术，术后过程良好。
