Transnasal endoscopic removal of bilateral postoperative maxillary cysts after aesthetic orthognathic ssurgery: Differences from that of Caldwell-Luc operations

The Antibiotic-Vaseline Soaked Cotton Pledget as an Adjuvant Material for Endoscopic Endonasal Fungal Ball Removal

Background and Objectives: Treatment choice for fungal ball is endoscopic endonasal removal. However, it is not easy to remove fungal elements from the maxilla using only an endonasal approach. To overcome this difficulty, we introduced a cotton pledget technique and evaluated its efficacy through a cadaveric study and clinical research.Materials and Method: A cadaveric study was performed using 10 half heads of seven cadavers. The ease and safety of the cotton pledget technique were compared to those of a previously reported technique. In clinical research, we enrolled 52 patients who underwent surgery with the cotton pledget technique and 36 patients who underwent surgery using the conventional endoscopic approach. Demographic factors, preoperative Lund-Mackay (LM) score, sinonasal outcome test (SNOT) score, surgical morbidity, and incomplete removal rate were analyzed.Results: The cadaveric study showed that the cotton pledget technique was easier (p=0.011) than the conventional technique. In addition, clinical evaluation showed that the cotton pledget group had significantly lower incomplete removal rate than that of the control group (p=0.010).Conclusion: The cotton pledget technique is an easy and safe method that enables fungal ball removal more effectively than the conventional technique without need for inferior meatal antrostomy (IMA) or the Caldwell-Luc (CL) approach.

Accidental Swallowing of Dental Implant: Complication of Transnasal Endoscopic Removal From Maxillary Sinus

Transnasal endoscopic removal of displaced dental implants in the maxillary sinus can be done easily under local anesthesia. However, very little is known regarding the precaution of this technique. In this report, we present the case of a 63-year-old man who visited the otolaryngologic department with a displaced dental implant in the maxillary sinus. Transnasal endoscopic removal of the displaced dental implant was planned and performed. However, the displaced dental implant was lost during removal. The implant was not seen in the other parts of the nasal cavity nor in the other parts of the oral cavity. Finally, radiographs revealed the presence of the dental implant at the level of the esophagus, although the patient did not notice anything because of local anesthesia. Thus, we conclude that operators should take into account the possibility of aspiration or swallowing of an implant through the posterior nasal aperture during the removal procedure. Precautions should be taken to avoid the possibility of implant aspiration or implant ingestion.