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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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A year-old woman visited an otorhinolaryngologist with 5-year history of nasal congestion. The mean SD V4 was When a tumor originates from a wide area, like that observed in our patient, it is important to use EMMM to allow the inside of the maxillary sinus to become visible, to control bleeding, to select forceps that can fully resect the lesion, and to ensure that the tumor has been fully resected. Findings in the nasal cavity were similar to those after ESS Figure 5and the patient did not complain of either an empty nose or dryness in the nose.

A methylene blue dye test was performed in these patients to evaluate the efficiency of the mucociliary clearance mechanism. Register for email alerts with links to free full-text articles Access PDFs of free jaxillectomy Manage your interests Save searches and receive search alerts.

In this patient, the sinonasal IP originated from maxiloectomy entire circumference of the maxillary sinus. We have observed no recurrence of the disease in any of these patients see Table 2.

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

As familiarity and expertise with endoscopic techniques increase, these approaches are being used more frequently in the extirpation of sinonasal tumors. Iatrogenic factors involve inadvertent stripping of sinus mucosa, damage to the cilia bearing endoscipic 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.


All of them had a wide middle meatal antrostomy, but the antral mucosa was found to be unhealthy with persistent disease. Purchase access Subscribe to the journal. Drafting of the manuscript: Radical medial maxillectomy is reserved for maxillary sinus tumors, which falls outside the range of discussion in this article.

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

The surgery was performed under general anesthesia. The posterior portion could be observed with a 0-degree endoscope and the anterior portion could be observed by degree endoscope.

The pyriform aperture and the mucosa of the inferior turbinate were sutured and the surgery was completed.

One patient with mucocele was referred for dacryocystorhinostomy maxlllectomy of epiphora. 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.

The inferior turbinate was found in its inherent position. Get free access to newly published articles.

Otolaryngol Clin North Am. Since IP was found at biopsy, she was referred to our hospital in order to undergo surgery. Following maxilletomy, a Merocel Medtronic, USA pack was kept maxullectomy the maxillary sinus and ethmoid cavity, which was removed after 5 days.

Tanna, Edwards, Aghdam, and Sadeghi. The patient maxlilectomy parenteral antibiotics during his or her stay in the hospital usually 24 hours and was discharged on oral medications.

Table 1 Types of modified endoscopic medial maxillectomy and indications. Both V4 and V1 carry a relatively normal distribution Figure 1 and Figure 2. Nineteen patients with no radiographic evidence of sinonasal disease or neoplasia were identified.

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.

Though the ciliary mechanism is lost, the goblet cells continue to secret mucus, which results in stasis, an additional factor. Sinonasal inverted papillomas IPs are one of most commonly found benign tumors in the maxilllectomy sinuses [ 1 ]. We have attempted to highlight this point through this article.


Our study is an attempt to define this subset of patients and a protocol for the treatment of these patients see Fig. Before surgery, IP must be diagnosed based on distinctive clinical and imaging findings of the nasal cavity. MRI T1 Gd-DTPA shows secondary maxillary sinusitis and a serpentine cerebriform filamentous structure, but there is no mass to otherwise indicate a possible origin.

Endlscopic endoscopic techniques entailed an extended maxillary antrostomy with piecemeal resection of tumor of the lateral nasal wall. Tanna, Edwards, and Aghdam. En block resection is desirable, but this is difficult with an endoscope owing to the limited visibility of the operative field. It is a true medial maxillectomy, involving resection of the entire lateral nasal wall.

In addition, it should provide wide access for extended resections when indicated. All procedures were done under general anesthesia. Abnormal dye test indicating disease of maxillary sinus mucosa. The superior maxillectoym inferior cuts are joined by the posterior cut using an osteotome. EMM or TA is recommended for stage T3, in which lesions exist on the maxillectoky side and the inferior, posterior, and anterior walls of the maxillary sinus.

As maxilpectomy popularity of the madillectomy continues to grow, however, so does the population of patients with postsurgical persistent sinus disease, especially in those with a large window for ventilation and drainage.

The contrast CT shows bone defects in the anterior and medial walls fndoscopic the maxillary sinus. Introduction Sinonasal inverted papillomas IPs are one of most commonly found benign tumors in the paranasal sinuses [ 1 ].

Create a free personal account to access your subscriptions, sign up for alerts, and more. Distribution of maxillary sinus volume inferior to the attachment of the inferior turbinate for 38 maxillary sinuses.