Effects of functional endoscopic sinus surgery on maxillary sinus mucosa.

OBJECTIVE

To compare the preoperative and postoperative changes on ciliary surface of maxillary sinus mucosa in patients treated with functional endoscopic sinus surgery.

DESIGN

The maxillary mucosa of both the superolateral wall and the ostium were sampled during the operation and 6 to 12 months (mean duration, 7.6 months) after the operation. Ciliary surface was determined using scanning electron microscopy in combination with an image analyzer and was expressed in terms of ciliary area, which is the percentage of mucosal surface occupied by cilia.

SETTING

The samples were taken at a hospital-based clinic. An electron microscopic study was performed at Mie University School of Medicine, Mie, Japan.

PATIENTS

Sixteen patients (20 maxillary sinuses) undergoing functional endoscopic sinus surgery for treatment of chronic sinusitis.

RESULTS

The mean (+/-SD) ciliary area before the surgery was 60.7%+/-28.8% and 39.9%+/-21.5% in the superolateral wall of the maxillary sinus and the ostium of the maxillary sinus, respectively. The ciliary area of the superolateral wall was significantly higher than that of the ostium (P<.001). The mean (+/-SD) postoperative ciliary area value was 74.3%+/-22.6% in the superolateral wall and 51.3%+/-16.1% in the ostium. These postoperative values were significantly higher than the preoperative values (P<.001).

CONCLUSIONS

This study showed that the maxillary sinus mucosa in chronic sinusitis is capable of regeneration, and the damaged ciliated epithelium could return toward normal with the improvement of ventilation and drainage of the maxillary sinus following functional endoscopic sinus surgery.