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Klimenko K.E.

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation;
Central Clinical Hospital with the Polyclinic of the Administrative Directorate of the President of the Russian Federation

Lebedeva A.A.

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation

Rusetsky Yu.Yu.

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation;
Central Clinical Hospital with the Polyclinic of the Administrative Directorate of the President of the Russian Federation

Kudryashov S.E.

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation;
Central Clinical Hospital with the Polyclinic of the Administrative Directorate of the President of the Russian Federation

Results of 90-degree endoscope application in removing foreign bodies and fungal balls from hard-to-reach areas of the maxillary sinus

Authors:

Klimenko K.E., Lebedeva A.A., Rusetsky Yu.Yu., Kudryashov S.E.

More about the authors

Journal: Russian Rhinology. 2025;33(1): 27‑35

DOI: 10.17116/rosrino20253301127

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Table of contents

RESULTS OF 90-DEGREE ENDOSCOPE APPLICATION IN REMOVING FOREIGN BODIES AND FUNGAL BALLS FROM HARD-TO-REACH AREAS OF THE MAXILLARY SINUS
RESULTS OF 90-DEGREE ENDOSCOPE APPLICATION IN REMOVING FOREIGN BODIES AND FUNGAL BALLS FROM HARD-TO-REACH AREAS OF THE MAXILLARY SINUS

To cite this article:

Klimenko KE, Lebedeva AA, Rusetsky YuYu, Kudryashov SE. Results of 90-degree endoscope application in removing foreign bodies and fungal balls from hard-to-reach areas of the maxillary sinus. Russian Rhinology. 2025;33(1):27‑35. (In Russ.)
https://doi.org/10.17116/rosrino20253301127

Подписка 2025-2 (Russian Rhinology)
 
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Endoscopic antrostomy through the middle nasal meatus (MNM) is a commonly accepted surgical treatment method for chronic inflammatory diseases of the maxillary sinus (MS). Due to the anatomical features of this area, the anteromedial areas often remain out of visual control even with a 70° endoscope and are hard-to-reach for manipulation by standard endoscopic instruments. However, it is essential to remove all pathological substrate in order to minimize the risk of revision intervention in the surgical treatment of foreign bodies and fungal balls of MS.

OBJECTIVE

To assess the effectiveness of the author’s method of applying the 90° endoscope in the surgical treatment of foreign bodies and/or fungal balls in hard-to-reach areas of MS through MNM.

PATIENTS AND METHODS

The results of surgical treatment of chronic maxillary sinusitis, caused by fungal ball and/or migration of foreign body into MS, using irrigation method, «gauze turunda» method and 90° endoscope were analyzed. The degree of MS visualization with the 90° endoscope, the frequency of cases when the 90° endoscope use affected the operation course, the frequency of the need for additional access, the surgery time and the quality of life of patients before and after the intervention were assessed.

RESULTS

The study included 39 patients (15 men and 24 women) with a mean age of 49.41±12.07 years. Fungal ball has been found in 20 (51.3%) patients, foreign body — in 11 (28.2%), combination of them — in 8 (20.5%). In 24 (61.5%) cases, the application of 90° endoscope allowed to reveal a pathological substrate that was not visualized using 70° endoscope. Additional prelacrimal access was applied in 2 (5.14%) cases and in 1 (2.7%) case a modified maxillectomy was performed. The use of 90° endoscope did not affect the operation time. There were no «large» or «small» perioperative and postoperative complications in patients, and the quality of life in the postoperative period, according to the SNOT-22 questionnaire, has improved significantly.

CONCLUSION

Application of endoscopic antrostomy through MNM using the 90° endoscope allows to detect pathological substrate and to completely remove the content of the MS in 92.2% of cases without formation of additional access.

Keywords:

maxillary sinus
endoscopic sinus surgery
prelacrimal access
revision endoscopic sinus surgery

Authors:

Klimenko K.E.

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation;
Central Clinical Hospital with the Polyclinic of the Administrative Directorate of the President of the Russian Federation

Lebedeva A.A.

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation

Rusetsky Yu.Yu.

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation;
Central Clinical Hospital with the Polyclinic of the Administrative Directorate of the President of the Russian Federation

Kudryashov S.E.

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation;
Central Clinical Hospital with the Polyclinic of the Administrative Directorate of the President of the Russian Federation

Received:

19.12.2023

Accepted:

17.01.2024

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