Features of the location of the sphenoid sinus determine the possibility of developing severe intraoperative complications in the surgical treatment of patients with chronic sphenoiditis. Technical difficulties during sphenoidotomy may arise at the initial stage of expansion of the natural anastomosis with its anatomical narrowness and the impossibility of inserting biting forceps.
PURPOSE OF THE STUDY
To study the clinical efficacy and safety of the proposed original method of dilatation of the sphenoid sinus fistula in the surgical treatment of various forms of chronic sphenoiditis.
MATERIAL AND METHODS
The study included 68 patients of both sexes older than 18 years with chronic sphenoiditis, who are indicated for surgery on the sphenoid sinus. Patients of the 1st group (n=36) underwent expansion of the fistula of the sphenoid sinus using the traditional method. Patients of the 2nd group (n=32) underwent dilatation of the anastomosis of the sphenoid sinus using the tool developed by us. Intraoperatively, the quality of visualization of the surgical field, the time of the operation, and the presence of complications were assessed. In the postoperative period, the number of complications, relapses of the disease and the condition of the sinus were recorded according to the results of computed tomography 3–4 months after the operation.
RESULTS
The use of the method of dilated expansion of the anastomosis of the sphenoid sinus using special forceps developed by us helps to reduce the duration of the operation, improve intraoperative visualization of the sphenoid sinus and improve the results of treatment according to endoscopy and control computed tomography. When using the developed tool, the number of episodes of intraoperative bleeding that hindered visualization and necessitated coagulation was lower than when using an alternative technique.
CONCLUSION
The technique of endoscopic dilatation of the anastomosis of the sphenoid sinus using the developed tool can be used both independently and as a preliminary step for expanding the anastomosis of the sphenoid sinus, followed by the use of a shaver or Kerrison forceps.
