resection of the medial and superomedial walls of the maxillary antrum. It is increasingly being done by transnasal endoscopic technique for suitable cases. the authors describe the endoscopic medial maxillectomy for neoplastic diseases involving the as operative technique for endoscopic medial maxillectomy. Conclusion Modified endoscopic medial maxillectomy appears to be an effective surgery for treatment of chronic, recalcitrant maxillary sinusitis.

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Administrative, technical, and material support: The inferior turbinate was found in its inherent position.

Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. For IP in the maxillary sinus, ESS is recommended for stage T2, in which lesions exist on the medial side and the superior wall of the maxillary sinus.

Therefore, volumetric analysis of 38 maxillary sinuses was performed. Though many would be reluctant to advocate a radical surgery like a medial maxillectomy for persistent maxillary sinusitis, it is imperative to understand the physiology and its alteration following surgery and chronic infection, which leads to a radical change in the functioning capacity of the maxillary sinus.

The mean SD V1 was jedial The mean SD V5 was The inferior turbinate bone was observed endoscopically and the conchal crest was cut with a chisel, allowing for the inferior portion of the nasolacrimal duct to be observed and for the inferior turbinate bone to be freely moved medially. Study concept and design: Transnasal endoscopic medial maxillectomy in inverted papilloma.

In addition, a magnetic resonance imaging MRI scan may show as the origin of IP, an inflammatory change on the opposite site of the unoccupied area, or a site where a serpentine cerebriform filamentous structure converges [ 8 ]. The inferior turbinate and the nasolacrimal duct could be moved to the medial side. Drs Tanna, Edwards, wndoscopic Sadeghi and Mr Aghdam had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.


En bloc specimen after transnasal endoscopic medial maxillectomy.

At present, there are no definitive guidelines for the treatment of this subset of patients. Findings revealed erosion or defects of the bone in the posterior and medial walls of the maxillary sinus, but the origin of IP could not be identified.

Endoscopic medial maxillectomy with preservation of inferior turbinate and nasolacrimal duct.

We wait 10 to 15 minutes then we looked for the movement of the dye. Drafting of the manuscript: We have attempted to highlight this point through this article. As the nasolacrimal duct could endoscopiv clearly observed by endoscope, the tumor deviating to the inferior meatus and the lateral mucosa and the bony wall of the inferior meatus could be sufficiently resected. Recently, a new surgical approach named endoscopic modified medial maxillectomy EMMM was proposed.

Nedoscopic Sinonasal inverted papillomas IPs are one of most commonly found benign tumors in the paranasal sinuses [ 1 ].

We have observed no recurrence of the disease in any of these patients see Table 2. In the nasal cavity, the tumor that was suspected to be IP was observed in the middle and inferior meatus Figure 1. Privacy Policy Terms of Use. Note that the middle turbinate, nasolacrimal duct, and anterior portion of the inferior turbinate are preserved Fig.

Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

Middle meatus and inferior meatal windows joined, creating a mega ostium, inferior turbinate partially resected. Our website uses cookies to enhance your experience.


A good visibility could be achieved and the tumor deviating to the inferior meatus could be sufficiently resected without any problems. Tanna, Edwards, and Aghdam. The nasolacrimal duct should be identified and preserved.

Postoperative observation of nasal cavity. Purchase access Subscribe to JN Learning for one year. Support Center Support Center. Top 10 reasons for endoscopic maxillary sinus surgery failure.

Postoperative nasal douching will be very effective for these patients. Our experience indicates that EMMM is an effective and relatively easy approach for treating IP that originated in the anterior, inferior, and medial walls of the maxillary sinus.

The goals of surgery are threefold: In case of inadvertent injury, it should be transposed higher, near the attachment of the middle turbinate Fig.

We selected EMMM because it allows for the preservation of the physiological function of the nose. Careful follow-up is essential to prevent recurrence or malignancy following surgery. Recently, endoscopy has played an important role in surgeries of the paranasal sinuses. EMM is an endonasal surgical procedure but does not appear to be a desirable approach because it necessitates the resection of the inferior turbinate and the cutting of the nasolacrimal duct, which impairs the function of the nose and may maxillectoy postoperative lacrimation [ 11 ].

Inverted papilloma may become malignant or complicated with cancer [ 23 ] and complete surgical resection is therefore essential for treatment. Indexed in Web of Science. An anterior cut passes through the inferior turbinate encompassing the inferior meatal opening. Manual of endoscopic sinus surgery and its extended applications; pp.

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