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The Use of 0° and 70° Endoscopes in Maxillary Antrostomy.

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Title: The Use of 0° and 70° Endoscopes in Maxillary Antrostomy.
Authors: Hentati, Firas, Kocharyan, Armine, Muller, Richard G., Ruthberg, Jeremy, Cabrera, Claudia I., D'Anza, Brian, Rodriguez, Kenneth
Source: Annals of Otology, Rhinology & Laryngology. Aug2023, Vol. 132 Issue 8, p873-878. 6p.
Subjects: Maxillary sinus surgery, Operative otolaryngology, Endoscopic surgery, Lacrimal apparatus, Health outcome assessment, Surgical complications, Endoscopes, Treatment effectiveness, Surveys, Comparative studies, Sinusitis, Descriptive statistics, Reoperation, Endoscopy, Longitudinal method, Disease risk factors, Evaluation
Abstract: Background and Objectives: Performing an effective maxillary antrostomy is critical to improving chronic maxillary sinusitis symptomatology. Incomplete dissection of the uncinate process and failure to incorporate the natural drainage pathway may lead to recirculation and need for revision surgery. The purpose of this study is to determine if 70° endoscopes provide added value in determining incomplete dissection or residual disease. Methods: Prospective study of 35 sinuses from 18 patients undergoing FESS for Chronic Rhinosinusitis (CRS) between 11/1/2020 and 4/30/2021. Two fellowship trained Rhinologists initially performed maxillary antrostomies exclusively using a 0° endoscope, then transitioned to a 70° endoscope. Surgeons completed a survey to assess completion of the antrostomy prior to use of 70° endoscope, sino-nasal anatomy, and difficulty of the operation. Intraoperative photographs before and after using a 70° endoscope were evaluated by a third party. Pre-operative CT scans were used to evaluate the sphenoid keel-caudal septum-nasolacrimal duct (SK-CS-NL) angle. Results: Of 35 sinuses from 18 patients all 35 sinuses had CRS with 48.5% having nasal polyposis and 42.9% having active infection. There was residual inflammatory tissue in the anterior maxillary sinus, including polypoid tissue and uncinate process prior to using the 70° endoscope in 82.9% of sinuses. The natural drainage pathway was not incorporated into the dissection in 28.6% of sinuses before converting to 70° endoscope. Incomplete dissection with 0° endoscope was not associated with nasal polyposis (P =.086) or uncinate position (0.741). Narrow SK-CS-NL angles were associated with incomplete dissection of the anterior maxillary sinus with 0° endoscope (16.0° ± 3.0° vs 20.6° ± 3.2°; P =.013). Conclusion: Use of 70° endoscope in maxillary antrostomy may be beneficial in identifying and resecting disease within the anterior maxillary sinus that may otherwise be difficult to find using a 0° endoscope. This is especially true in patients with narrow nasolacrimal duct positioning. [ABSTRACT FROM AUTHOR]
Copyright of Annals of Otology, Rhinology & Laryngology is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: The Use of 0° and 70° Endoscopes in Maxillary Antrostomy.
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  Data: <searchLink fieldCode="AR" term="%22Hentati%2C+Firas%22">Hentati, Firas</searchLink><br /><searchLink fieldCode="AR" term="%22Kocharyan%2C+Armine%22">Kocharyan, Armine</searchLink><br /><searchLink fieldCode="AR" term="%22Muller%2C+Richard+G%2E%22">Muller, Richard G.</searchLink><br /><searchLink fieldCode="AR" term="%22Ruthberg%2C+Jeremy%22">Ruthberg, Jeremy</searchLink><br /><searchLink fieldCode="AR" term="%22Cabrera%2C+Claudia+I%2E%22">Cabrera, Claudia I.</searchLink><br /><searchLink fieldCode="AR" term="%22D'Anza%2C+Brian%22">D'Anza, Brian</searchLink><br /><searchLink fieldCode="AR" term="%22Rodriguez%2C+Kenneth%22">Rodriguez, Kenneth</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Annals+of+Otology%2C+Rhinology+%26+Laryngology%22">Annals of Otology, Rhinology & Laryngology</searchLink>. Aug2023, Vol. 132 Issue 8, p873-878. 6p.
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  Data: <searchLink fieldCode="DE" term="%22Maxillary+sinus+surgery%22">Maxillary sinus surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Operative+otolaryngology%22">Operative otolaryngology</searchLink><br /><searchLink fieldCode="DE" term="%22Endoscopic+surgery%22">Endoscopic surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Lacrimal+apparatus%22">Lacrimal apparatus</searchLink><br /><searchLink fieldCode="DE" term="%22Health+outcome+assessment%22">Health outcome assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Surgical+complications%22">Surgical complications</searchLink><br /><searchLink fieldCode="DE" term="%22Endoscopes%22">Endoscopes</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Surveys%22">Surveys</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22Sinusitis%22">Sinusitis</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Reoperation%22">Reoperation</searchLink><br /><searchLink fieldCode="DE" term="%22Endoscopy%22">Endoscopy</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation%22">Evaluation</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background and Objectives: Performing an effective maxillary antrostomy is critical to improving chronic maxillary sinusitis symptomatology. Incomplete dissection of the uncinate process and failure to incorporate the natural drainage pathway may lead to recirculation and need for revision surgery. The purpose of this study is to determine if 70° endoscopes provide added value in determining incomplete dissection or residual disease. Methods: Prospective study of 35 sinuses from 18 patients undergoing FESS for Chronic Rhinosinusitis (CRS) between 11/1/2020 and 4/30/2021. Two fellowship trained Rhinologists initially performed maxillary antrostomies exclusively using a 0° endoscope, then transitioned to a 70° endoscope. Surgeons completed a survey to assess completion of the antrostomy prior to use of 70° endoscope, sino-nasal anatomy, and difficulty of the operation. Intraoperative photographs before and after using a 70° endoscope were evaluated by a third party. Pre-operative CT scans were used to evaluate the sphenoid keel-caudal septum-nasolacrimal duct (SK-CS-NL) angle. Results: Of 35 sinuses from 18 patients all 35 sinuses had CRS with 48.5% having nasal polyposis and 42.9% having active infection. There was residual inflammatory tissue in the anterior maxillary sinus, including polypoid tissue and uncinate process prior to using the 70° endoscope in 82.9% of sinuses. The natural drainage pathway was not incorporated into the dissection in 28.6% of sinuses before converting to 70° endoscope. Incomplete dissection with 0° endoscope was not associated with nasal polyposis (P =.086) or uncinate position (0.741). Narrow SK-CS-NL angles were associated with incomplete dissection of the anterior maxillary sinus with 0° endoscope (16.0° ± 3.0° vs 20.6° ± 3.2°; P =.013). Conclusion: Use of 70° endoscope in maxillary antrostomy may be beneficial in identifying and resecting disease within the anterior maxillary sinus that may otherwise be difficult to find using a 0° endoscope. This is especially true in patients with narrow nasolacrimal duct positioning. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Annals of Otology, Rhinology & Laryngology is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1177/00034894221119306
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 6
        StartPage: 873
    Subjects:
      – SubjectFull: Maxillary sinus surgery
        Type: general
      – SubjectFull: Operative otolaryngology
        Type: general
      – SubjectFull: Endoscopic surgery
        Type: general
      – SubjectFull: Lacrimal apparatus
        Type: general
      – SubjectFull: Health outcome assessment
        Type: general
      – SubjectFull: Surgical complications
        Type: general
      – SubjectFull: Endoscopes
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Surveys
        Type: general
      – SubjectFull: Comparative studies
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      – SubjectFull: Sinusitis
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Reoperation
        Type: general
      – SubjectFull: Endoscopy
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Disease risk factors
        Type: general
      – SubjectFull: Evaluation
        Type: general
    Titles:
      – TitleFull: The Use of 0° and 70° Endoscopes in Maxillary Antrostomy.
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            – D: 01
              M: 08
              Text: Aug2023
              Type: published
              Y: 2023
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