Đánh giá kết điều trị nội soi cắt vách mũi xoang cải tiến tại bệnh viện Tai Mũi Họng TP.HCM

Abstract

Objective: Evaluate The Outcomes Of Modified Endoscopic Medial Maxillectomy At Ent Hospital HCMc. Methods: A retrospective and prospective study describing a series of cases with 96 maxillary sinuses of 90 patients underwent Modified Endoscopic Medial Maxillectomy from November 2019 to November 2022  at HCMC ENT Hospital. Result: In 90 cases, 60 patients had previous maxillary sinus surgery. The most common causes for MEMM are mucoceles (42,2%), recalcitrant maxillary sinusitis (33,3%). The mean follow-up time was 12,58 months. Preoperative and postoperative SNOT-22 score of patients who underwent MEMM are 9,91 and 4,99. There was a statistically significant reduction of Lund Kenedy scores for all durations of follow-up, Preoperative and postoperative are 3,8 and 2,1. 30 patients with persistent maxillary sinus disease, with 67,7 % reporting complete or significant improvement, 33.3% reporting partial improvement, and 0% reporting worsening. There are 2 cases of complications of nasolacrimal duct injury and postoperative bleeding. All patients had good disease control in postoperative visits with no clinical evidence of recurrences. Conclusion: The goals of surgery are threefold: complete extirpation of all allergic mucin and fungal debris, permanent drainage and ventilation for the affected sinuses while maintaining intact mucosa, and postoperative access to the previously diseased areas. MEMM has overcome some limitations of medial maxillectomy surgery or  Caldwell Luc surgery such as scabbing, loss of maxillary sinus function, scarring.