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Results of endoscopic maxillary mega-antrostomy in recalcitrant maxillary sinusitis.
Am J Rhinol. 2008 Nov-Dec; 22(6):658-62.AJ

Abstract

BACKGROUND

In patients with chronically diseased maxillary sinuses, poor mucociliary clearance may result from long-standing inflammation or scarring from previous surgery. This subset of patients often has persistent sinus disease despite medical therapy and adequate antrostomy. Endoscopic maxillary mega-antrostomy (EMMA) is a mucosal sparing technique that facilitates mucus clearance and sinus irrigation in terminally dysfunctional maxillary sinuses. EMMA involves extending the antrostomy through the posterior half of the inferior turbinate down to the floor of the nose, creating a significantly enlarged antrostomy. This study describes our results of EMMA in recalcitrant maxillary sinusitis.

METHODS

A retrospective review was performed of patients who underwent EMMA for recalcitrant maxillary sinusitis between July 2005 and September 2007. We studied diagnoses, comorbid factors, clinical efficacy, revision rate, and complications.

RESULTS

Twenty-eight patients (average age, 48 years) underwent 42 EMMAs for recalcitrant maxillary sinusitis. Average follow-up was 11 months. All patients had previous maxillary sinus surgery (mean = 2.3). Relevant comorbid factors included prior Caldwell-Luc or maxillofacial surgery (16/42), cystic fibrosis (11/42), asthma (11/42), and IgG deficiency (3/42). The most common symptoms reported were facial pain/pressure and purulent rhinorrhea. At the time of the most recent postoperative examination, 74% of patients reported complete resolution of symptoms while 26% reported partial symptomatic improvement. There were no complications and the revision rate was 0%.

CONCLUSION

Maxillary sinuses that appear to be terminally diseased may be rehabilitated surgically without the need for surgical stripping. EMMA is an effective and safe treatment option for the management of recalcitrant maxillary sinus disease.

Authors+Show Affiliations

Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California 94305-5739, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19178809

Citation

Cho, Do-Yeon, and Peter H. Hwang. "Results of Endoscopic Maxillary Mega-antrostomy in Recalcitrant Maxillary Sinusitis." American Journal of Rhinology, vol. 22, no. 6, 2008, pp. 658-62.
Cho DY, Hwang PH. Results of endoscopic maxillary mega-antrostomy in recalcitrant maxillary sinusitis. Am J Rhinol. 2008;22(6):658-62.
Cho, D. Y., & Hwang, P. H. (2008). Results of endoscopic maxillary mega-antrostomy in recalcitrant maxillary sinusitis. American Journal of Rhinology, 22(6), 658-62. https://doi.org/10.2500/ajr.2008.22.3248
Cho DY, Hwang PH. Results of Endoscopic Maxillary Mega-antrostomy in Recalcitrant Maxillary Sinusitis. Am J Rhinol. 2008 Nov-Dec;22(6):658-62. PubMed PMID: 19178809.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Results of endoscopic maxillary mega-antrostomy in recalcitrant maxillary sinusitis. AU - Cho,Do-Yeon, AU - Hwang,Peter H, PY - 2009/1/31/entrez PY - 2009/1/31/pubmed PY - 2009/3/24/medline SP - 658 EP - 62 JF - American journal of rhinology JO - Am J Rhinol VL - 22 IS - 6 N2 - BACKGROUND: In patients with chronically diseased maxillary sinuses, poor mucociliary clearance may result from long-standing inflammation or scarring from previous surgery. This subset of patients often has persistent sinus disease despite medical therapy and adequate antrostomy. Endoscopic maxillary mega-antrostomy (EMMA) is a mucosal sparing technique that facilitates mucus clearance and sinus irrigation in terminally dysfunctional maxillary sinuses. EMMA involves extending the antrostomy through the posterior half of the inferior turbinate down to the floor of the nose, creating a significantly enlarged antrostomy. This study describes our results of EMMA in recalcitrant maxillary sinusitis. METHODS: A retrospective review was performed of patients who underwent EMMA for recalcitrant maxillary sinusitis between July 2005 and September 2007. We studied diagnoses, comorbid factors, clinical efficacy, revision rate, and complications. RESULTS: Twenty-eight patients (average age, 48 years) underwent 42 EMMAs for recalcitrant maxillary sinusitis. Average follow-up was 11 months. All patients had previous maxillary sinus surgery (mean = 2.3). Relevant comorbid factors included prior Caldwell-Luc or maxillofacial surgery (16/42), cystic fibrosis (11/42), asthma (11/42), and IgG deficiency (3/42). The most common symptoms reported were facial pain/pressure and purulent rhinorrhea. At the time of the most recent postoperative examination, 74% of patients reported complete resolution of symptoms while 26% reported partial symptomatic improvement. There were no complications and the revision rate was 0%. CONCLUSION: Maxillary sinuses that appear to be terminally diseased may be rehabilitated surgically without the need for surgical stripping. EMMA is an effective and safe treatment option for the management of recalcitrant maxillary sinus disease. SN - 1050-6586 UR - https://www.unboundmedicine.com/medline/citation/19178809/Results_of_endoscopic_maxillary_mega_antrostomy_in_recalcitrant_maxillary_sinusitis_ L2 - https://medlineplus.gov/endoscopy.html DB - PRIME DP - Unbound Medicine ER -