Abstract
We developed a new endonasal procedure (transsubmucosal maxilloethmoidal sinus surgery through the inferior turbinate) for chronic sinusitis and present the theoretical ground as well as an outline of the procedure. This technique yielded satisfactory results with a good postoperative clinical progress and no complications. Results were evaluated after one year by classifying changes in the maxillary sinus into 5 types. Better pneumatization was seen in cases where the mucosal membrane of the maxillary sinus was kept intact, whereas various changes occurred in cases where the mucosal membrane of the maxillary sinus was resected. On immunohistological investigation, immunological staining of the mucosal membrane of the inferior turbinate and the mucosal membrane around the natural ostia was conducted using monoclonal mouse anti-human mast cell tryptase (Daco-Mast Cell, AA1). Cases were divided by the presence or absence of allergy involvement, but no significant difference was found. It may be concluded from these results that this new procedure is useful for chronic sinusitis irrespective of the presence or absence of allergy involvement.
