Free nasal floor mucosal grafting after endoscopic total ethmoidectomy for severe nasal polyposis: a pilot study.

Autor:	Moreno-Luna R; Rhinology Unit, Department of Otolaryngology, Hospital Universitario Virgen de la Macarena, Seville, Spain., Gonzalez-Garcia J; Rhinology Unit, Department of Otolaryngology, Hospital Universitario Virgen de la Macarena, Seville, Spain., Maza-Solano JM; Rhinology Unit, Department of Otolaryngology, Hospital Universitario Virgen de la Macarena, Seville, Spain., Molina-Fernandez E; Rhinology Unit, Department of Otolaryngology, Hospital Universitario Virgen de la Macarena, Seville, Spain., Pinheiro-Neto CD; Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, Albany Medical Center, Albany, NY, USA., Del Cuvillo Bernal A; Rhinology and Asthma Unit, ENT Department, Hospital de Jerez, Jerez de la Frontera, Cadiz, Spain., Langdon C; Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Clinical and Experimental, Respiratory Immunology, IDIBAPS, Hospital Clinic i Universitari, Barcelona, Spain., Sanchez-Gomez S; Rhinology Unit, Department of Otolaryngology, Hospital Universitario Virgen de la Macarena, Seville, Spain.
Jazyk:	angličtina
Zdroj:	Rhinology [Rhinology] 2019 Jun 01; Vol. 57 (3), pp. 219-224.
DOI:	10.4193/Rhin18.178
Abstrakt:	Background: We report a novel surgical technique based on an endonasal free mucosal graft (mucoplasty) for improving clinical results and local healing in chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: Patients diagnosed with bilateral CRSwNP scheduled for endoscopic sinus surgery were included. They underwent complete removal of anterior and posterior ethmoid cells, in addition to bilateral type III frontal sinusotomy. An endoscopic mucoplasty was performed in the left nasal cavity, whereas the right nasal cavity served as control. Patients were evaluated before surgery and 6 months after operation, including Sino-Nasal Outcome Test (SNOT-22), Visual Analogue Scale (VAS) for olfaction, endoscopic evaluation using the Modified und-Kennedy (MLK) scoring system and healing evaluation. Results: Ten patients (mean age 53.6 years) were included. A significa t decrease of SNOT-22 score from 57.0 (21.1) to 20.3 (20.6) (P = 0.024) and a non-significa t decrease of VAS for olfaction score from 9.3 (0.5) to 4.6 (3.9) were found. Preoperative mean MLK score was 4.9 (0.7) in the right nostril and 4.8 (1.0) in the left one. After operation, there was a greater decrease of MLK score in the left nostril than in the right (1.9 [1.0] vs. 1.3 [0.8], P = 0.034). Better healing was proved in the nostril with the mucoplasty. Conclusion: Endonasal mucoplasty could be an effective, safe and feasible complementary surgical procedure in the treatment of CRSwNP. The reduced local edema associated with lower amount of secretions may confer a better control in the frontal recess, orbital wall and nasal roof.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu