Maxillary Sinus Mucosal Prolapse: A Pilot Study Describing a New Technique for Intraoperative Management

Year 2024, Volume: 7 Issue: 1, 17 - 20, 13.05.2024

Usamah Hadi Helene Dabbous Jad Hosri Nadine El Hadi Zeina Korban

https://izlik.org/JA48HL68UB

Abstract

Objectve: Functional endoscopic sinus surgery is primarily aimed at restoring the natural physiology of the paranasal sinuses to achieve effective mucociliary clearance and proper ventilation. This can be hindered by various factors, including host-related, environmental, and iatrogenic factors. Preservation of the sinus mucosa is fundamental for the success of the surgery. Sinus mucosal prolapse, resulting from intraoperative mucosal trauma, can lead to sinus ostium obstruction and impaired drainage.

Methods: In this pilot study, the authors describe a novel technique for the intraoperative management of sinus mucosal prolapse arising from endoscopic sinus surgery. This method entails the use of a balloon catheter expander to inflate and support the maxillary sinus mucosa, thereby limiting the occurrence of preventable prolapse-related complications.

Results: The authors applied this surgical technique to a cohort of 11 patients. All patients developed prolapse affecting the posterosuperior region of the maxillary sinus mucosa. Each patient was followed up for at least 3 weeks following the surgery, and endoscopic assessment postoperatively revealed absent mucosal prolapse in all patients, highlighting the success and positive outcomes of the technique. The sinus mucosa retained its appropriate positioning, effectively draping the sinus wall in uninterrupted continuity with the maxillary antrostomy.

Conclusion: The authors advocate the use of a Foley catheter as a cost-effective and readily available alternative to the traditional balloon sinus catheter expander.

Keywords

Maxillary sinus , prolapse , rhinology , transnasal endoscopic surgery

References

• Cohen NA, Kennedy DW. Revision endoscopic sinus surgery. Otolaryngol Clin North Am. 2006;39(3):417-vii.
• Levine CG, Casiano RR. Revision functional endoscopic sinus surgery. Otolaryngol Clin North Am. 2017;50(1):143-164.
• Ramadan HH. Safety and feasibility of balloon sinuplasty for treatment of chronic rhinosinusitis in children. Ann Otol Rhinol Laryngol. 2009;118(3):161-165.
• Kariya S, Okano M, Hattori H, et al. Expression of IL-12 and T helper cell 1 cytokines in the fluid of paranasal sinus mucoceles. Am J Otolaryngol. 2007;28(2):83-86.
• Kshar A, Patil A, Umarji H, Kadam S. Mucopyocele of the maxillary sinus. Dent Res J (Isfahan). 2014;11(1):119-123.
• Rodrigues CD, Freire GF, Silva LB, Fonseca da Silveira MM, Estrela C. Prevalence and risk factors of mucous retention cysts in a Brazilian population. DentoMaxillo Fac Radiol. 2009;38(7):480-483.
• Hunt SM, Tami TA. Sinusitis-induced enophthalmos: the silent sinus syndrome. Ear Nose Throat J. 2000;79(8):576-584.
• Hosemann W, Draf C. Danger points, complications and medico-legal aspects in endoscopic sinus surgery. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2013;12:Doc06.
• Shipchandler TZ, Batra PS, Citardi MJ. Sinonasal mucosal wound healing: implications for contemporary rhinologic surgery. In: Essential Tissue Healing of the Face and Neck. Hom DB, Hebda PA, Gosain AK, Friedman CD, eds. Shelton, CT: People’s Medical Publishing House; 2009:161-180.