maxillary sinus fenestration

The intranasal fenestration of the maxillary sinus is to open a large window in the outer side wall of the lower nasal passage, and open into the maxillary sinus, so that the sinus pus is easy to drain, which is a conservative drainage operation. Treatment of diseases: chronic maxillary sinusitis Indication Maxillary sinus intranasal fenestration applies to: 1. Subacute or recurrent maxillary sinusitis, which can be recovered during the intermittent period. 2. Mild chronic maxillary sinusitis, failed to cure after repeated puncture irrigation. 3. Chronic maxillary sinusitis, long-term empyema, but no obvious hyperplasia of sinus mucosa, mucosal epithelium is expected to recover. 4. Children with maxillary sinusitis, after repeated maxillary sinus puncture irrigation is not cured, should first open the maxillary sinus window. Contraindications 1. Chronic maxillary sinusitis with long-term empyema, sinus mucosa with obvious thickening and polypoid changes. 2. Chronic maxillary sinusitis associated with maxillary osteitis or osteomyelitis. 3. Maxillary sinus cyst or tumor. 4. Chronic maxillary sinusitis has alveolar fistula. Preoperative preparation 1. Cut the nose hair and shave the beard. 2. On the night before surgery, take Xixi (Dingding) 5mg. Surgical procedure 1. Use a long dilatation or flat stripper to fracture the inferior turbinate from the lateral side of the inferior turbinate and then turn up to better expose the lateral wall of the lower nasal passage. 2. Make a vertical incision at the outer side wall of the lower nasal passage about 1 cm behind the front end of the inferior turbinate. Make another vertical incision at 1.5 to 2.0 cm after the incision. Make two parallel incisions on the upper and lower incisions to separate the periosteum and remove the mucosa. Expose the lower nasal wall. A parallel incision can also be made on the two vertical incisions to retain the mucosa, and the mucosa is turned into the sinus cavity after opening the window. 3. Open the window and puncture the maxillary sinus to the maxillary sinus at the exposed bone wall of the lower nasal passage. Then use the Luc bite forceps to bite the posterior superior and inferior bone wall. Use Ostrum forward rongeur to bite the anterior and inferior bone wall before the puncture hole, so that the window is about 2cm before and after, about 1.5cm up and down. The lower turbinate is reset after opening the window. 4. If there is not much bleeding during hemostasis surgery, there is no need to fill it. If there is bleeding, you can fill the window and the lower nasal passage with iodoform gauze. complication 1. The primary and subsequent hematopoietic blood can be used to fill the nasal cavity and the maxillary sinus cavity. It is advisable to use antibiotics for systemic treatment following the release of blood. 2. The adhesion of the inferior turbinate to the nasal septum can be prevented if the nasal mucosa is contracted daily with ephedrine after surgery.

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