Topic
Ethmoidectomy
About: Ethmoidectomy is a research topic. Over the lifetime, 950 publications have been published within this topic receiving 19617 citations.
Papers published on a yearly basis
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Papers
TL;DR: The Messerklinger technique as discussed by the authors is a primarily diagnostic endoscopic concept demonstrating that the frontal and the maxillary sinuses are subordinate cavities, with infections of these latter sinuses thus usually being of secondary nature.
Abstract: The Messerklinger technique is a primarily diagnostic endoscopic concept demonstrating that the frontal and the maxillary sinuses are subordinate cavities. Disease usually starts in the nose and spreads through the ethmoidal prechambers to the frontal and maxillary sinuses, with infections of these latter sinuses thus usually being of secondary nature. Standard rhinoscopy and sinus X-rays are frequently not sufficient to demonstrate the underlying causes for chronic or recurring acute sinusitis in the clefts of the anterior ethmoidal sinuses. The combination of diagnostic endoscopy of the lateral nasal wall with conventional or computed tomography in the coronal plane has proven to be the ideal method for the examination of inflammatory diseases of the paranasal sinuses. In so doing, diseases and lesions that other-wise might have gone undiagnosed can be identified and consequently treated. Based on this diagnostic approach, an endoscopic surgical concept was developed, aiming for the underlying causes of sinus diseases instead of the secondarily involved larger sinuses. With usually very limited surgical procedures, diseased ethmoid compartments are operated on, stenotic clefts widened and prechambers to the frontal and maxillary sinuses freed from disease. In our experience, there is rarely a need for major manipulations inside the larger sinuses per se. Based on exact diagnosis, the surgical technique used allows a very individualized staging according to the prevailing pathology. In the extreme, a total sphenoethmoidectomy can be performed with this technique, although the true advantage of the technique is that even in cases of massive disease such radical procedures can be avoided. By reestablishing sinus ventilation and drainage via the natural ostia, there is also no need for fenestration of the inferior meatus. The Messerklinger technique can be applied to a wide spectrum of indications, apart from nasal polyposis. The technique has its clear limits as well as its specific problems. Adequate training and experience are required for the surgical approach, as the technique bears all the risks and hazards of all kinds of endonasal ethmoid surgery but has a minimal complication rate in the hands of an experienced surgeon. Results and complications of a series of more than 4500 patients over a period of over 10 years are presented and discussed in detail.
953 citations
TL;DR: Obstruction of the antro-nasal foramen is, due to its high location, not a likely complication, nor is the occurrence of severe haemorrhages since the trap door is in the periphery of the supplying vessels.
Abstract: Inadequate bone height in the lateral part of the maxilla forms a contra-indication for implant surgery. This condition can be treated with an internal augmentation of the maxillary sinus floor. This sinus floor elevation, formerly called sinus lifting, consists of a surgical procedure in which a top hinge door in the lateral maxillary sinus wall is prepared and internally rotated to a horizontal position. The new elevated sinus floor, together with the inner maxillary mucosa, will create a space that can be filled with graft material. Sinus lift procedures depend greatly on fragile structures and anatomical variations. The variety of anatomical modalities in shape of the inner aspect of the maxillary sinus defines the surgical approach. Conditions such as sinus floor convolutions, sinus septum, transient mucosa swelling and narrow sinus may form a (usually relative) contra-indication for sinus floor elevation. Absolute contra-indications are maxillary sinus diseases (tumors) and destructive former sinus surgery (like the Caldwell-Luc operation). The lateral sinus wall is usually a thin bone plate, which is easily penetrated with rotating or sharp instruments. The fragile Schneiderian membrane plays an important role for the containment of the bonegraft. The surgical procedure of preparing the trap door and luxating it, together with the preparation of the sinus mucosa, may cause a mucosa tear. Usually, when these perforations are not too large, they will fold together when turning the trap door inward and upward, or they can be glued with a fibrin sealant, or they can be covered with a resorbable membrane. If the perforation is too large, a cortico-spongious block graft can be considered. However, in most cases the sinus floor elevation will be deleted. Perforations may also occur due to irregularities in the sinus floor or even due to immediate contact of sinus mucosa with oral mucosa. Obstruction of the antro-nasal foramen is, due to its high location, not a likely complication, nor is the occurrence of severe haemorrhages since the trap door is in the periphery of the supplying vessels. Apart from these two aspects, a number of anatomical considerations are described in connection with sinus floor elevation.
561 citations
TL;DR: The olfactory test administered to patients at the Connecticut Chemosensory Clinical Research Center combines stability of outcome with sensitivity to variables known to affect olfaction (age, sex).
Abstract: The olfactory test administered to patients at the Connecticut Chemosensory Clinical Research Center combines stability of outcome with sensitivity to variables known to affect olfaction (age, sex). The test, which pairs an odor threshold component with an odor identification component, readily resolves differences in function between patients and controls. It reveals differences in the distribution of functioning for various probable causes (nasal/sinus disease, postupper respiratory infection, and head trauma), proves sensitive to improvements in function caused by therapeutic intervention (ethmoidectomy, steroid administration for nasal/sinus disease), and correlates with objective signs of nasal/sinus disease (visual exam, x-ray). The two components of the test agree well, though the odor identification component seems somewhat more sensitive than the threshold component as currently designed.
536 citations
TL;DR: The author reports on a concept, developed over a 10-year experience with 1,080 patients, for treating chronic pansinus disease by an endonasal micro- and endoscopic technique, either alone or in combination with an external (osteoplastic) approach.
Abstract: The author reports on a concept, developed over a 10-year experience with 1,080 patients, for treating chronic pansinus disease by an endonasal micro- and endoscopic technique, either alone or in combination with an external (osteoplastic) approach. He describes techniques and indications for simple drainage, extended drainage, or medium drainage of the frontal sinus. Patients who have already undergone several frontal sinus procedures can be treated definitively by combining a procedure using a transfrontal external approach (osteoplastic procedure) with fat obliteration of the frontal sinus, and endonasal micro-endoscopic ethmoidectomy. Because of inflammatory orbital periostitis, subperiosteal abscess, orbital phlegmon, or intracranial complications (meningitis, encephalitis), the endonasal micro-endoscopic approach was used to operate on 47 of 389 patients who underwent procedures for simple, extended, or median drainage of the frontal sinus.
390 citations
Journal Article•
TL;DR: Transnasal ethmoidectomy for diffuse polyposis consists of the removal of the ethmoidal cell septa, including the middle turbinate, and a broad fenestration of both the sphenoid sinus and the frontal infundibulum.
Abstract: Endonasal sinus surgery aims at the preservation of a lining mucosa in the reventilated and redrained cavities. It can, therefore, be confined to the removal of narrowing bone at the "isthmus" of the ducts or windows. Transnasal ethmoidectomy for diffuse polyposis consists of the removal of the ethmoidal cell septa, including the middle turbinate, and a broad fenestration of both the sphenoid sinus and the frontal infundibulum. A consequent postoperative care provided, transnasal ethmoidectomy offers excellent clinical results. A new suction-irrigation endoscope and refined instruments contribute to improved surgical exposure and to the avoidance of complications.
333 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2025 | 5 |
| 2024 | 6 |
| 2023 | 12 |
| 2022 | 28 |
| 2021 | 19 |
| 2020 | 10 |