Impact of draining mode of enlarged maxillary ostium on mucociliary transportation system
10.3321/j.issn:1673-0860.2008.04.004
- VernacularTitle:上颌窦自然开口开放方式对上颌窦纤毛传输途径的影响
- Author:
Cheng-Li XU
1
;
Ke-Jun ZUO
;
Geng XU
Author Information
1. 中山大学附属第一医院(耳鼻咽喉科医院)
- Keywords:
Maxillary sinus;
Mucociliary transport;
Otorhinolaryngologic suigical procedures
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2008;43(4):259-262
- CountryChina
- Language:Chinese
-
Abstract:
Objective The purpose of this study was to investigate the proper site for enlarging maxillary natural ostium during ESS,and to compare the draining mode of mucociliary trasportation system.Methods Three groups were designed to observe the differences of tracer agent transported from maxillary sinus to nasal cavity.Normal control group:30 cases;Trial group A:30 cases,the maxillary natural ostium were radically enlarged by all sides:Trial group B:30 cases,the maxillary natural ostiums were enlarged by reservation of whole inferior edge and cut away anterior and/or posterior edge.The patients in two trial groups were after nasal endoscopic sinus surgery for more than 12 monthes and the maxillary ostiums were well open.Results Tracer agent was drained from maxillary sinus to nasal cavity by inferior edge(s) of natural ostium in control group.The core area was posterior part of inferior edge.In trial group A,tracer agent was drained out by inferior edge in 4 cases (13.3%),tracer agent drained out by posterior and/or superior edge(s) and then dispersed to ethmoid sinus in 17 cases (56.7%),tracer agent stacked and/or circularlly flowed in the maxillary sinus,and could not be transported out in 9 cases (30.0%).In trial group B,tracer agent drained out by inferior edge to middle meatal in all subjects (30/30,100%),and there was no redirection of the mucociliary transportation.Conclusions The inferior edge of natural ostium is the main passage of mucociliary transportation system of maxillary sinus.If the inferior edge of maxillary natural ostium reserved,the post-operative drainage of maxillary sinus would be the same as normal ones. Radical removal of all edges of maxillary natural ostium could lead to redirection of mucociliary transportation,only few cases could drain out by inferior edge,most cases drained out by posterior and/or superior edge and then dispersed to ethmoid sinus.In some cases,tracer agent often stacked in the maxillary sinus and could not be drained out.When there was a need to enlarge the maxillary natural ostium in ESS, it should be done in the anterior and/or posterior edge of natural ostium,the inferior edge should not be damaged so as not to interfere the passage of mucociliary trasportaion system of the maxillary sinus.
