Maxillary ostium preservation in ethmoidectomy.
Fiche publication
Date publication
octobre 2023
Journal
European annals of otorhinolaryngology, head and neck diseases
Auteurs
Membres identifiés du Cancéropôle Est :
Pr JANKOWSKI Roger
Tous les auteurs :
Pollet-Thiollier A, Jankowski R, Rumeau C, Nguyen DT
Lien Pubmed
Résumé
The paranasal sinuses play a role in producing and storing nitric oxide (NO). NO is a powerful antiviral and antibacterial gas which may be involved in the non-specific immune defenses of the respiratory tract. Conducted by the inspiratory current at the alveolar-capillary membrane, it increases pulmonary venous blood oxygenation. NO is actively released in the form of independent boluses in the respiratory tract, thanks to a sphincter function that can be identified during ethmoidectomy under general anesthesia. Safeguarding paranasal sinus physiology necessarily involves conserving this ostial sphincter function, which is essential to the respiratory role of the paranasal sinuses. Although it has not yet been demonstrated that the destruction of this ostial function has measurable consequences for respiratory function, it makes sense to avoid systematic antrostomy and to preserve this ostial function whenever possible, depending on the clinical conditions. This technical note describes step-by-step how to conserve the maxillary ostium, in the example of radical ethmoidectomy with mucosal ablation for nasal polyposis (nasalization). It is illustrated by two videos. The discussion focuses on the respective indications for ostial preservation and middle meatotomy (antrostomy).
Mots clés
Antrostomy, Ethmoidectomy, Meatotomy, Respiratory physiology, Sinus drainage, Sinus ventilation
Référence
Eur Ann Otorhinolaryngol Head Neck Dis. 2023 10 25;: