S. Matsune, I. Miyanohara, Y. Kurono

Dept. of Otolaryngology, Faculty of Medicine, Kagoshima University,

JAPAN

Introduction: YAMIK sinus catheter (YAMIK) was invented by Markov and Kozrov in Russia in 1983, and has been practically used there since 1985. In 1991, it was introduced to Japanese otolaryngologists in the ISIAN meeting held in Tokyo. Through the practical trial of 60 sinusitis cases by Kagoshima University and Kansai Medical University, the catheter was approved to be imported for clinical use by our government in 1998. In 2000, YAMIK became a choice of methods for sinus irrigation on national health insurance base. We have already tried in more than 250 cases in the outpatient clinic. In this lecture, our practical use of YAMIK and its effect on sinusitis will be shown.

Materials and Methods: Acute or chronic sinusitis cases without nasal polyp were basically indicated to YAMIK with oral medication. (1) Sinusitis cases were classified into two groups with/without nasal allergy and compared, symptomatically and radiologically, the effect between them. (2) In cases with nasal allergy, YAMIK was applied after polypotomy. (3) Pathogen was also studied by checking the sinus effusion obtained by YAMIK.

Results: (1) YAMIK was quite effective, symptomatically and radiologically, in sinusitis cases with/without nasal allergy. (2) Sinusitis cases after polypotomy can be good indication for YAMIK. (3) Bacterial data by YAMIK did! not show obvious difference from the data of the samples obtained in the middle meatus. Lipopolysaccharide (LPS). of gram negative rod (GNR) bacteria was detected extensively even in cases that GNR bacteria was not detected

Discussion: Recently, sinusitis with allergy seems to be increasing cases. Even in such cases, YAMIK can be a therapeutic choice if the catheter is not so irritating intranasaly for the patients. Polypotomy was considered to increase the chance to use YAMIK. Combination with the laser poiypotomy may be a quite convenient therapy in outpatient clinic. Data of LPS in the sinus effusion is thought to support the importance of drainage by YAMIK.

Conclusion: YAMIK is a quite effective and convenient therapeutic device on sinusitis in outpatient clinic.