[Endoscopic treatment of patients with paranasal sinusitis and co-occurring anatomic disorders in nasal patency]

Abstract

Introduction: The aim of the study was to evaluate the frequency of co-occurrence of anatomic disorders within the nasal area in patients suffering from chronic paranasal sinusitis.

Material and methods: Between 2006-2008 there were 446 endoscopic operations performed on patients with chronic paranasal sinusitis. Apart from paranasal sinuses surgeries, 172 patients underwent an additional operation on anatomic deviations within the nasal area. The study group included 98 women and 74 men. First, the nasal septoplasty was performed in a typical way according to the Cottle's principles with the use of endoscope, which was followed by functional endoscopic operations on paranasal sinuses. The middle concha bullosa operations were performed by opening the pneumatisized bony part and removing the lateral part.

Results: Among 446 patients who underwent endoscopic treatment due to chronic paranasal sinusitis substantial anatomic disorders were found in 38.6% of the cases qualifying the patients for further surgical procedures. Simultaneously, bilateral plasties of the middle concha bullosa were conducted in 25.1% of the cases whereas 10.3% of the patients underwent lateral operations on the middle concha bullosa. In the studied group the septoplasty was performed in 37.4% of the cases. Rarely unilaterally, with the use of endoscope, we removed spines or ledges from the nasal septum in 19.5% and 7.7% of the cases respectively. Moreover, 14 patients underwent operations on the nasal septum and middle concha bullosa at the same time. The co-occurrence of the spine in the nasal septum and middle concha bullosa was found in 6 operated patients. Bilateral middle concha bullosa and nasal septum ledge were operated three times.

Conclusions: The anatomic causes of disorders in nasal patency were frequently found in the studied material. Thus, it proves their substantial part in patomechanism of paranasal sinusitis. Correcting anatomical anomalies ought to be performed simultenously with the operation within the paranasal sinuses. Endoscopically controlled limited septoplasty is a crucial element of complex surgical approach in the paranasal sinusitis.