G.C.Passali, C. Biagini, D. Passali

ENT department university of Siena medical school, Siena, Italy

Rhinosinusitis is certainly one of the most common disorders encountered by primary care physicians and ENT specialists, according with the International Rhinosinusitis advisory Board (1997).

It is possible to identify different forms of rhinosinusitis: Acute, Recurrent, Chronic and Acute Exacerbations of Chronic forms. Of course this is only a clinic classification based on the duration of the symptoms and for clinical practice. Each form is caused by different kind of infective agents both viral and bacterial. The physiopathology is still a debated topic; a fundamental role is certainly played by the sinus Ostium, anatomic formation whose role is to allow the correct aeration of the paranasal sinus and the efficacy of the mucociliary transport; alterations of this structure permit the proliferation of pathologic agents and the development of the disease.

The therapy of paranasal sinuses pathology is always very difficult to manage, especially because to reach these regions of the human body systemic therapy is needed. In our Department we have been using for 5 years the sinus catheter YAMIK, a particular latex catheter. It consists of a body with two inflatable balloons and two valves, one on either side. In the body a flexible rod allows shaping of it to the anatomy of the nasal cavity. The proximal inflating balloon is mobile along the catheter body and contains also a rigid tube that form the working passage of the catheter. The two balloons permit the isolation of the nasal cavity and with a syringe, through the working tube, is possible to create an alteration of positive and negative pressure that leads to the cleaning of the sinuses from the pathological secretions. Usually during this action the patient do not have any pain, on the contrary has a relieve from the headache. Finally the working passage can be used to fill the paranasal sinuses with antibiotic or anti-inflammatory solution for a really effective topic therapy, that is difficult to achieve with any other method.