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https://hdl.handle.net/2440/52218
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Type: | Journal article |
Title: | Pre- and Postoperative Sinus Penetration of Nasal Irrigation |
Author: | Grobler, A. Weitzel, E. Beule, A. Jardeleza, C. Cheong, Y. Field, J. Wormald, P. |
Citation: | The Laryngoscope, 2008; 118(11):2078-2081 |
Publisher: | Lippincott Williams & Wilkins |
Issue Date: | 2008 |
ISSN: | 0023-852X 1531-4995 |
Statement of Responsibility: | Alethea Grobler, Erik K. Weitzel, Achim Buele, Camille Jardeleza, Yew C. Cheong, John Field, Peter-John Wormald |
Abstract: | OBJECTIVE/HYPOTHESIS: Endoscopic sinus surgery is an accepted treatment for medically recalcitrant chronic rhinosinusitis. Effective saline douching may improve long-term outcomes of chronic rhinosinusitis but is often impaired by postoperative ostial stenosis. The aim of this study is to determine a critical ostial size at which douching solution reliably enters the sinus cavities. STUDY DESIGN: Prospective study of consecutive patient cohort. METHODS: Seventeen preoperative or well-healed postoperative endoscopic sinus surgery patients were irrigated with 5 mL blue food coloring mixed with 200 mL buffered saline from a squeeze bottle. The degree of sinus penetration, sinus ostial patency, and ostial size were endoscopically determined. RESULTS: Sinuses penetrated by blue dye had a significantly larger minimal ostial dimension (7.31 mm; 95% confidence interval 5.54-9.08) than those that had no blue dye penetration (1.26 mm; 95% confidence interval 0.86-1.66) as determined by Student t test. Chi-square analysis showed that operated sinuses were more likely to be penetrated than nonoperated sinuses (P = .0016) and obstructed sinuses (P = .0325). Logistic regression showed a 95% probability of penetration when the minimum ostial dimension is 3.95 mm or greater. CONCLUSIONS: Unoperated sinuses or cases with gross sinus ostial obstruction will not be reliably penetrated by sinus irrigant. A 3.95-mm ostial diameter seems to be the minimum size to guarantee penetration in paranasal sinuses to maximize the potential for topical sinus treatment. |
Keywords: | Endoscopic sinus surgery nasal irrigation sinus ostia stenosis nasal douche. |
DOI: | 10.1097/MLG.0b013e31818208c1 |
Published version: | http://dx.doi.org/10.1097/mlg.0b013e31818208c1 |
Appears in Collections: | Aurora harvest 5 Surgery publications |
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