What Is Pilonidal Sinus Surgery?

Endoscopic maxillary sinus surgery is a surgical procedure.

Endoscopic maxillary sinus surgery

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Endoscopic maxillary sinus surgery is a surgical procedure.

Endoscopic maxillary sinus surgery

Maxillary sinus surgery under nasal endoscope; Maxillary sinus surgery under nasal endoscope; Maxillary sinus endoscopy

Otorhinolaryngology / Nose and Sinus Surgery / Endoscopic Nasal Sinus Sinus Surgery

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Endoscopic maxillary sinus surgery is suitable for:

1. Chronic recurrent maxillary sinusitis can not be cured for a long time.

2. Fungal maxillary sinusitis.

3. Maxillary sinus cyst.

4. Maxillary sinus polyps.

5. Maxillary sinus foreign body.

1. Identify diagnostic and surgical indications and exclude contraindications.

2. Read the film carefully to determine the surgical plan.

3. Routine preoperative examination (blood routine, platelet, liver and kidney function, coagulation function, electrocardiogram and chest radiograph).

4. Signature before surgery.

5. Use antibiotics 1 to 3 days before surgery.

6. Cut the nose hair 1d before the operation.

7. Intramuscular hemostatic medicine 30min before surgery.

8. General anesthesia according to general anesthesia.

Topical or local anesthesia.

1. Removal of the hook process, see ethmoid sinus surgery.

2. Find and expand the natural mouth of the maxillary sinus. Maxillary sinus ostium positioning is important, and sometimes it is difficult to see the sinus ostium directly under endoscope. The maxillary sinus opening is between the ethmoidal vesicle and the hook process. After the hook process is removed, you can use a curved curette or curved suction head to carefully explore the attachment of the inferior turbinate. If purulent secretions overflow, Or small bubbles appear, which usually indicate the location of the natural maxillary sinus opening. The natural mouth of the sinus mouth may be covered by nearby polyps, granulation or mucus secretions. The sinus mouth can be seen after cleaning. The reasons for the natural opening of the maxillary sinus are not easily identifiable as follows: A. The diseased mucosa covers or closes the natural opening of the maxillary sinus; B. The stump of the uncinate process covers the maxillary sinus opening downward; Thorough resection of the bone at the tail of the hook process is the key to finding and expanding the natural mouth of the maxillary sinus. If the natural maxillary sinus opening is difficult to identify, you can use a 5mm maxillary sinus cannula puncture needle to penetrate the maxillary sinus through the canine fossa, insert an endoscope, and explore the natural opening through the middle nasal passage under bright vision, which is beneficial to reduce orbital complications. After the curved suction device head or probe is inserted into the maxillary sinus, the inner wall and membrane of the maxillary sinus can be bitten forward and backward by scissors and reverse bite forceps, respectively, and then the lower wall of the natural mouth can be bitten. Enlarging the natural mouth of the maxillary sinus to 1.5cm × 1.5cm and keeping the upper mucosa of the natural mouth intact is an important measure to prevent postoperative narrowing of the natural mouth. If you see the maxillary sinus accessory mouth, you should connect the accessory mouth to the natural opening. Do not enlarge the maxillary sinus opening in a ring to avoid ring stenosis after surgery. When expanding the maxillary sinus opening forward, be careful not to damage the nasolacrimal duct. The bone wall of the nasolacrimal duct is hard and easy to identify.

3. Clear the lesions in the maxillary sinus. Under 30 ° or 70 ° endoscopic observation, purulent or viscous secretions are aspirated through the enlarged natural opening of the maxillary sinus. Mucosal lesions are not heavy, and the mucosa should be retained. The sinus anhydride casein and fungal mass should be completely removed, otherwise there will still be pus after operation. The cyst should be completely removed to prevent recurrence. Severe polyp-like mucous membranes can be aspirated with a suction device. The parts that cannot be aspirated indicate that the edema is not obvious and can be retained. Pedicled polyps can be used with a curette. During benign tumor resection, if the tumor invades the maxillary sinus, the sinus mucosa is scraped with a curette. If necessary, a maxillary sinus cannula can be used to penetrate the maxillary sinus through the canine fossa, insert endoscopes or surgical instruments, and clear the maxillary sinus lesions through the combined approach of the canine fossa and the middle nasal passage.

During the operation, be careful not to damage the orbital wall above the sinus, the anterior lacrimal duct, the sphenoidal duct, and the lower inferior turbinate.

1. The middle nasal canal is stuffed as appropriate after the operation. The stuffing materials include swelling sponge, absorbable hemostat, gelatin sponge and oil gauze.

Remove the stuffing after 24 to 48 hours.

3. Apply antibiotics as appropriate.

4. Clean up the nasal cavity 1 to 2 days after surgery.

5. After taking out the nasal cavity stuffing, nasal drops of 5 to 6 times / d with furancilin, ephedrine and ephedrine nasal drops were taken for 5 to 7 days.

6. Rinse the nasal cavity daily with saline.

7. Postoperative use of hormones (systemic or local) as appropriate.

8. Oral diluted mucin 300mg, 3 times / d.

9. Follow-up for at least six months after operation. In case of regeneration or scar formation of small polyps, it should be treated in time.