ENDOSCOPIC MEDIAL MAXILLECTOMY PDF

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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Those authors, however, limited the use of their technique to inverting papillomas originating from the ethmoid, sphenoid, or medial wall of the maxillary sinus. These patients are still symptomatic due to recirculation phenomenon where there is circular movement of the mucous around the artificially created window.

The nasolacrimal duct should be identified and preserved. It was believed that IP originated from a wide area. Simmen D, Jones N S.

It is important to note that these patients have been operated on previously with varying degrees of damage to the mucous membrane. In addition, it should provide wide access for extended resections when indicated.

This allows for full access to the maxillary sinus, including the anterior and lateral walls, the ethmoid sinuses, and the anterior wall of the sphenoid sinus.

However, EMM usually removes the inferior turbinate and nasolacrimal duct. We have observed no recurrence of the disease in any of these patients see Table 2. Otolaryngol Head Neck Surg. All of the IPs were adhering to the posterior wall. Cadaveric resection of the lateral nasal wall via transnasal maxilectomy medial maxillectomy demonstrating the defect and specimen.

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Case Reports in Otolaryngology

Many of these lesions, including inverted papillomas, have shown favorable outcomes with transnasal endoscopic resections. Table of Contents Alerts.

Critical revision of the kedial for important intellectual content: In patients with a normally functioning sinus, this movement can be observed within minutes of instilling the dye. Findings revealed erosion or defects of the bone in the posterior and medial walls of the maxillary medal, but the origin of IP could not be identified.

The patients on whom we have operated can be likened to those suffering from cystic fibrosis as there is partial or complete loss of normal mucosa and hence mucociliary clearance due to the previous surgery. They recommend type III for extensive sinus disease, antrochoanal polyp removal, and previous surgery.

Inverted papilloma is observed behind the uncinate process and inferior meatus.

Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

Both V4 and V1 carry a relatively normal distribution Figure 1 and Figure 2. Top 10 reasons for endoscopic maxillary sinus surgery failure. We feel that merely taking down the medial wall of the maxillary antrum does not serve the purpose in patients with irreversible mucosal injury and necessitates a more radical procedure like a type IIb MEMM.

The inferior turbinate was preserved. Postoperative observation of nasal cavity. Average follow-up was Endoscopic medial maxillectomy is a radical procedure that includes removal of uncinate process, bulla, inferior turbinate, middle turbinate, and medial maxillary wall with the nasolacrimal duct.

Iatrogenic factors involve inadvertent stripping of sinus mucosa, damage to the cilia bearing mucosa with the microdebrider or other instruments, exposure of bone, circumferential damage to the sinus ostium, improper widening of sinus ostium permitting recirculation of mucous, poor mucociliary clearance, among others.

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

The details of the patients are listed in Table 2. These patients had undergone multiple endoscopic mefial elsewhere or in our center in the past but were still symptomatic. We suspected a maxillectoy change of IP or a complication of cancer and performed another biopsy, concluding that the condition was IP.

Purchase access Subscribe to the journal. We advocate a surgery that would ensure gravity-dependent drainage of the sinus as it will be the only means for drainage in the absence of viable mucosa.

Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

This is performed for patients with delayed dye clearance. It is a true medial maxillectomy, involving resection of the entire lateral nasal wall. Type I Modified Endoscopic Medial Maxillectomy The procedure involves removal of intervening tissue between the two windows.

Administrative, technical, and material support: Sinonasal inverted papillomas IPs are one of most commonly found benign tumors in the paranasal sinuses [ 1 ]. Slightly posterior to the pyriform aperture, the mucosa was incised from the superior portion of the inferior turbinate towards the nasal floor, and the nasal mucosa was elevated from the lateral wall of the nasal cavity.

Purchase access Subscribe to JN Learning for one year. Details of the surgery are described in the Surgical Method section.