Observation Of The Drainage Of Maxillary Sinus After Functional Endoscopic Sinus Surgery

Objective:1. To observe the drainage methods of maxillary sinus after functional endoscopic sinus surgery(FESS)for patients with chronic maxillary sinusitis.2. Analysis of the relationship between the drainage way and curative effect.3. To explore the most suitable nasal meatus maxillary sinus ostium processing technology in endoscopic,.Methods:1.Clinical data of 156 patients with CRS treated nasal endoscopic maxillary sinus surgery from September 2012 to September 2013 were retrospectively. another choose 30 cases of no significant maxillary sinus inflammation of subjects(do not make any processing) as control group, cases patients followed up 12 months.2.After follow-up of 12 months with methylene blue was used as tracer agent in this study. nasal endoscopic observation of methylene blue in maxillary sinus drainage time, way, etc. And compared with normal control group in maxillary sinus drainage way.3. Sino-nasl outcome test-20( SNOT-20) and visual analogue scale(VAS) were evaluated preoperative and 1 years postoperative patients quality of life and main symptoms. The Lund- Kennedy scoring objective curative effect evaluation.4. The data were analysed with SPSS19.0Result:1.Tracer and sinus secretions in normal maxillary sinus all came out from the natural drainage opening, the half moon crack at the bottom to hook tu tail below the inclined back in again after the nasal passages in inferior turbinate backend into the nose pharynx ministry.2.Follow-up of 1 year, case group 162 cases, 6 cases(3.70%)lost to follow-up. This study assessed by the statistical result is not statistically significant. Complete follow-up of 156 patients with maxillary sinusitis, 84 case of conventional expand maxillary sinus natural openings, 72 case of hook no handled sudden sinus excision. All patients drainage time of tracer in maxillary sinus obviously prolong than the normal control group, have obvious difference with normal maxillary sinus drainage way. The conventional expand maxillary sinus natural openings abnormal obviously, 34 case(40.47%) patients showed multi-direction drainage. 15 case(20.83%) of patients with multi-directional drainage in hook no handled sudden sinus excision group, Still have difference with normal maxillary sinus drainage. Normal control group, conventional group expand maxillary sinus natural openings, simple hook other structures around the sudden removal of sinus treatment group, the statistical analysis have differences between groups(P < 0.05).Tests in the two groups were slow, no visible drainage drainage phenomenon.3. After 12 months treatment significant differences in VAS score,SNOT- 20 score and Lund- Kennedy score between preoperative,and significant differences in VAS score,SNOT- 20 score and Lund- Kennedy score between two kinds of surgical methods after 12 months treatment(P < 0.05).Conclusions:1.Normal nasal and sinus structures is necessary to maintain the function of nasal cavity and sinuses, and sinus surrounding normal structures is necessary for normal function of the maxillary sinus drainage.2.Dealing with the structure around maxillary sinus ostium in the process of nasal endo scopic surgery changes the way of the maxillary sinus drainage, which may cause or ag gravate adverse postoperative maxillary sinus drainage.3.Dealing with maxillary sinus ostium should different under different conditions, and t ry to retain sinus surrounding structure to make a natural recovery state.