A six-month analysis of frontal sinus drainage pathway in patients with frontal sinusitis after balloon sinuplasty.

BACKGROUND: The balloon catheter has been used for a decade to dilate paranasal sinus outflow tracts. The question is: how wide and how durable is the dilation of drainage pathways in patients in long-term observations after this procedure? OBJECTIVE: The objective of our study was to observe the changes occurring in the frontal sinus drainage pathway (FSDP) in patients with frontal sinusitis at least 6 months after surgery using balloon catheters in an isolated procedure. MATERIALS AND METHODS: We analyzed and measured the FSDP width on computed tomography (CT) of 23 images before and after the use of balloon catheters. We also assessed mucosal changes using Zinreich's scale, and symptom improvements with the Sino-Nasal Outcome Test (SNOT-20). RESULTS: A statistically significant difference in the width of the FSDP was found before and after sinuplasty in the study group (p ≤ .0016). On average, the FSDP increased by 24.1%. Clinically meaningful and statistically significant (p ≤ .0002) symptom improvement as indicated by the mean SNOT-20 score was observed. Mucosal changes were also statistically significant (p ≤ .0018) after surgery. CONCLUSION: The findings at least 6 months after follow-up indicated that the use of balloon catheters in an isolated procedure allowed durable modeling of FSDP and was associated with radiological and clinical improvements.

Minimally invasive transnasal approach for primary ectopic meningioma of the paranasal sinuses.

Endoscopic sinus surgery is a standard procedure in the treatment of various pathologies such as chronic sinusitis or some types of neoplasms. The transnasal approach to tumours of paranasal sinuses is favourable due to functional and aesthetic reasons. We report a rare case of a large primary ectopic meningioma of the paranasal sinuses in a 48-year-old woman referred to the Otolaryngology Clinic due to the incidental finding of a pathologic mass visualised on the orthopantomography picture. After diagnosis, the patient was successfully treated with radical transnasal surgery performed under endoscopic vision. In a 1-year follow-up there were no signs of tumour recurrence.

Evaluation of fully biodegradable nasal packings in functional endoscopic sinus surgery ­ a multi-centre study.

THE AIM: This work was to compare an innovative solution, i.e. a fully biodegradable nasal packing Nasopore®, with a traditional one, in the aftercare of patients subjected to functional endoscopic sinus surgery. MATERIAL AND METHOD: Prospective, blinded study with sequential enrollment conducted at three study centres. One of the investigators evaluated during surgery the level of bleeding in each of the nasal cavities and at the end of surgery he applied the test packing, the biodegradable dressing Nasopore®, to one randomly chosen nasal cavity, and a control packing to the other one. The other investigator removed during aftercare the control packing and conducted the follow-up. During the control visits (24-48 hours, 10 and 30 days post-op.) the subjects evaluated their headache, pain in the nose, pressure in the forehead as well as their nasal obstruction. RESULTS: A total of 39 women and 44 men at the age of 47 years on average (min. 19, max. 82) were qualified for the study. The largest differences between different types of nasal dressings were observed with regard to reduction of nasal obstruction in the fist 10 days after surgery (P<0.005). In relation to the pain in the area of the head and nose as well the pressure in the forehead on every visit, better outcomes were observed for the test dressing. Statistical difference (P<0.05) was observed on the fist follow-up visit for the headache and pressure in the forehead as well as on the fist and second visit for the pain in the nose. CONCLUSION: The fully biodegradable nasal dressing Nasopore® may constitute significant improvement and facilitation of aftercare in functional endoscopic sinus surgery while increasing the patients' satisfaction and lowering the postoperative discomfort.