Abstract
The results of endoscopic sinus surgery were evaluated with the computed tomography scans (CT) which were taken before and after the surgery. At first, the volume of the lumen in the inflammatory maxillary sinus (V. L.) and the volume of the maxillary sinus (V. M.) were measured with CT. Then the percentage of V. L./V. M. were compared with preoperative and postoperative stage. The patients were separated into three groups. Group A (35sinuses). bilateral chronic sinusitis; in this group, the fontanelle and maxillary ostium were not treated surgically. Group B (15 sinuses). bilateral chronic sinusitis; in this group, the fontanelle and maxillary ostium were widened surgically. Group C (seven sinuses). unilateral chronic sinusitis; in five sinuses of this group, the fontanelle and maxillary ostium were not treated surgically, in two sinuses the fontanelle and maxillary ostium were widened surgically.
The results were as follows: 1. The percentage of V. L/V. M of the postoperative stage were more than that of the preoperative stage in all three groups (p<0.01). 2. The degree of the differentiation of the percentage between preoperative stage and postoperative stage of group C was more than those of group A, group B and Group A+B (p<0.01). 3. The degree of the differentiation of the percentage between preoperative and postoperative stage of group B was more than that of group A.
We concluded as the following: 1. Performing the endoscopic sinus surgery, the surgical techniqe with widening the fontanelle and maxillary ostium may get better result for healing the maxillary sinus than that without widening the fontanelle and maxillary ostium, but when it is difficult to perform by former method because of bleeding or anatomical problems, operating by latter method with sufficient following treatment will be able to expect nice results. 2. The pathogenesis of bilateral chronic sinusitis and unilateral chronic sinusitis may be different. The combination of local and whole body conditions may be important for the cause of bilateral chronic sinusitis, on the other hand, the local condition may play an important part for the cause of unilateral chronic sinusitis.
