抄録
In this paper, we discuss the results of endoscopic endonasal sinus surgery for diffuse chronic sinusitis characterized by nasal polyposis, especially the effects of postoperative long-term administration of low-dose erythromycin (EM). EM therapy (long-term and low-dose) is now recognized as an effective method for the treatment of panbronchiolitis.
Our surgical technique is performed under local anesthesia, and involves removal of the anterior and posterior ethmoidal cells via the middle meatus. We attempt to leave the mucosa of the ethmoid roof intact. Next, sufficient communication between the ethmoid sinus and both the maxillary and frontal sinuses is achieved under endoscopic observation.
We analyzed 117 patients in whom diffuse chronic sinusitis was treated by endoscopic endonasal sinus surgery. These initial surgical cases (over 15 years old) have been followed up for more than 9 months postoperatively. The improvement rate in the clinical symptoms (nasal obstruction, nasal discharge, postnasal discharge, etc.), determined by questionnaire, the improvement rate of maxillary sinus lesions, and also the postoperative conditions of the ethmoid sinus, nasofrontal duct, fontanelle and maxillary sinus are analyzed. Furthermore, we compared the results in the EM administration (long-term and low-dose) group (25 cases) with the results in a non-EM administration group (92 cases).
We found that the long-term (3 months-6 months) administration of low-dose EM postoperatively achieves significantly better results than conventional endoscopic endonasal sinusectomy without EM. Also, EM was confirmed to be a safe drug.
