RECURENCE OF SINUSITIS AFTER ENDONASAL SURGERY: REVISION SURGERY OR TREATMENT BY YAMIK METHOD?
RECURENCE OF SINUSITIS AFTER ENDONASAL SURGERY: REVISION SURGERY OR TREATMENT BY YAMIK METHOD? A.S.Shilenkov Yaroslavl, Russia
Surgical intervention in cases of chronic sinusitis does not exclude possibility of recurrence of pathological process in sinuses in postoperative period. Main reasons of it can be viral or bacterial respiratory infection, common decreasing the level of immunodefence, allergic reactions, environmental factors. Conservative treatment of the sinusitis recidivating in the some cases finished with revision surgery.
Aim of investigation was to crate a scheme of postoperative treatment of recurrent sinusitis which would be give possibility to exclude revision surgery.
Under observation were 67 patients with recurrence sinusitis after endonasal surgery. Average age was 43,4 years. Most of the patients (43) had purulent form of sinusitis and 24 patients suffered by recurrence of polyps. All patients were divided on two groups. First one (46 patients) were treated by YAMIK method and patients from the second group (21 patients) were treated by traditional methods (oral antibiotics, decongestants and topical steroids under indications). The scheme of YAMIK treatment had consisted of YAMIK procedures two times in a week with introducing in sinuses antibiotics and nasal lavage by saline solution in the intervals between procedures. Topical steroids were used under indications in cases of polypose sinusitis.
The results of treatment were analyzed after three weeks of treatment by using endoscopy, rhinomanometry and acoustic rhinometry. We had found that in 89,4% of patients from the first group nasal discharge disappear after first week of treatment but in the second group only in 56,7% nasai discharge was stopped after two weeks of treatment, in the first group in most of the cases the fadal pain finished after first YAMIK procedure, in another group facial pain continued up to the beginning of second week. Endoscopic examination had showed disappearance of polyps after three weeks of treatment in all patients the first group and only in 67,3% of patients in the second group. The treatment by YAMIK method allowed us to refused revision surgery in all patients. In the second group 5 patients were reoperated according non effective treatment. Treatment sinusitis recurrence after endonasal surgery by YAMIK method is highly effective and allow to decrease an amount of revision surgery.
