Obliterative sinusitis: An underreported clinical entity

Tips and tricks for management of the dysfunctional maxillary sinus

PURPOSE OF REVIEW

To review the various factors associated with the most common cause of maxillary sinus dysfunction; recalcitrant chronic maxillary sinusitis (RCMS). In addition, available medical and surgical management options are discussed along with various tips and tricks for optimal management.

RECENT FINDINGS

Defects in mucociliary clearance, immunodeficiency, anatomic factors, and infectious etiologies have been implicated in dysfunction of the maxillary sinus leading to RCMS. Medical management including oral antibiotics or topical drugs have shown varying degrees of success. Endoscopic modified medial maxillectomy (EMMM) has been shown to significantly improve symptoms in patients with RCMS.

SUMMARY

A dysfunctional maxillary sinus presents a clinical challenge. A thorough evaluation of any potential contributing factors must be done in addition to an assessment of the adequacy of prior surgical treatment of the maxillary sinus. Beyond the middle meatal antrostomy, EMMM can be used to effectively address RCMS. In cases that fail EMMM, removal of the condemned mucosa to encourage auto-obliteration of the sinus can be considered.

Effect Evaluation of Preoperative Psychological Nursing Intervention on Sinusitis Patients Undergoing General Anesthesia by Multiplanner Reformation-Based CT

The aim of this study was at exploring the clinical effect of CT images based on multiplanner reformation (MPR) combined with a preoperative psychological nursing intervention model in sinusitis patients undergoing general anesthesia. Sixty sinusitis patients who received MPR-based CT examination and general anesthesia were selected as the study subjects and randomly divided into the control group (n = 30) and the experimental group (n = 30). The control group used traditional preoperative education. The experimental group added the psychological nursing intervention based on traditional preoperative education. The blood pressure and heart rate before and after the operation, the self-rating anxiety scale (SAS) score before and after intervention, and satisfaction were comprehensively assessed. The results showed that CT based on MPR could observe the lesions and anatomical structures of the sinus wall and sinus in detail from multiple angles. The blood pressure (systolic blood pressure 135.12 ± 14.89 mmHg, diastolic blood pressure 87.05 ± 11.24 mmHg), heart rate (78.42 ± 12.19 beats/min), SAS score (45.85 ± 4.97 points), and nursing satisfaction (78.9%) of the experimental group were significantly better than those of the control group (145.83 ± 15.62 mmHg, 94.21 ± 10.86 mmHg, 86.44 ± 13.65 beats/min, 56.44 ± 5.12 points, 56.4%), and the differences were statistically significant (P < 0.05). In summary, the preoperative psychological care model has a positive role in reducing the tension and anxiety of patients before general anesthesia surgery and CT based on MPR is important for the clinical diagnosis and treatment of sinusitis. This study provides a theoretical reference for the clinical treatment of patients with sinusitis.