抄録
Clinical applications of transoral endoscopic sinus surgery (TESS) for odontogenic maxillary sinusitis are reported.
Patients and methods: These procedures were carried out for odontogenic maxillary sinusitis without another sinusitis, confirmed by image diagnosis. Two holes of 5 mm in diameter were made in the frontal wall of the maxillary sinus about 5 mm above the apex of the first premolar for installing the fiberscope and for inserting the instruments. When the infection was found, the inner surface of the sinus was rinsed. After cleaning the sinus, opening of its ostium was confirmed endoscopically. Fifteen procedures were carried out in 14 patients (average age of 44.1 years).
Results: The TESS was performed in 12 cases. Counter ostium opening was used together with TESS in one case and maxillary sinusotomy was used in two cases. The average operating time was 1.49 hours, and the average bleeding during surgery was 57.5 grams. Twelve cases were evaluated on the prognosis for an average of 13.3 months postoperatively, but the 3 cases followed for less than 6 months were excluded. Among the 12 cases followed-up, 8 cases showed no problems in image examination and clini calevaluations 4 cases with clinical problems or with some findings in image examinations were seen, but one case needed additional treatment for abscess.
Discussion: The TESS procedure proposed here simply involves: evaluating the sinus with endoscopy, rinsing it, and confirming the condition of the ostium by non-invasive methods.
