Alromaih Saud R, Alsayed Ahmed, Aloraini Nouf M, Aldajani Ahmad, Alrasheed Abdulaziz, Alroqi Ahmad, Aloulah Mohammad, Alsaleh Saad
Department of Otolaryngology-Head & Neck Surgery, King Saud University, Riyadh, Saudi Arabia.
Department of Otolaryngology-Head & Neck Surgery, University of Jeddah, Jeddah, Saudi Arabia.
Ear Nose Throat J. 2023 Jun 26:1455613231181713. doi: 10.1177/01455613231181713.
Inferior meatal antrostomy (IMA) is a safe and easy approach to the maxillary sinus. However, studies have shown disadvantages of conventional IMA, such as disruption of mucociliary transport and injury of the nasolacrimal duct (NLD). Endoscopic middle meatal antrostomy (MMA) has become the standard of care for addressing various maxillary pathologies. It is more functional and physiological but offers limited exposure to certain areas of the maxillary sinus, such as the prelacrimal recess, alveolar recess, and zygomatic recess. We proposed submucosal temporary inferior maxillary antrostomy (STIMA) to improve visualization and accessibility to such difficult-to-access locations. To describe our proposed modification, to compare the degree of visualization and ease of accessibility between MMA and STIMA. This is a descriptive cadaveric study. It was performed on 4 fresh frozen human cadavers, and 8 maxillary sinuses were used to achieve the study's objectives. Different angled rigid nasal endoscopes and suction tubes were used to score the degree of visualization and ease of accessibility between the MMA and STIMA. We demonstrated the superiority of the STIMA over the MMA in the degree of visualization and ease of accessibility in these difficult-to-access locations (-value was significant, <.05). We did not encounter orbital injury or injury to the NLD in our specimens. STIMA is a relatively easy and safe modification of conventional IMA. It improves the degree of visualization and ease of accessibility to difficult-to-access maxillary sinus locations without the potential complications of conventional IMA.
下鼻道上颌窦造口术(IMA)是一种安全且简便的进入上颌窦的方法。然而,研究表明传统IMA存在一些缺点,例如破坏黏液纤毛运输和损伤鼻泪管(NLD)。内镜中鼻道上颌窦造口术(MMA)已成为治疗各种上颌病变的标准术式。它更具功能性和生理性,但对上颌窦某些区域,如泪前隐窝、牙槽隐窝和颧隐窝的暴露有限。我们提出了黏膜下暂时性上颌窦下造口术(STIMA),以改善对这些难以到达区域的可视化和可达性。描述我们提出的改良方法,比较MMA和STIMA之间的可视化程度和可达性难易程度。这是一项描述性尸体研究。对4具新鲜冷冻的人体尸体进行了研究,使用8个上颌窦来实现研究目标。使用不同角度的硬性鼻内镜和吸引管对MMA和STIMA之间的可视化程度和可达性难易程度进行评分。我们证明了在这些难以到达的位置,STIMA在可视化程度和可达性难易程度方面优于MMA(-值具有显著性,<.05)。在我们的标本中未遇到眼眶损伤或鼻泪管损伤。STIMA是对传统IMA相对简单且安全的改良。它提高了对上颌窦难以到达位置的可视化程度和可达性,且没有传统IMA的潜在并发症。