Radiologic assessment of diseased mucosa of the maxillary sinus after functional endoscopic sinus surgery.
We attempted to evaluate postoperative mucosal changes and symptomatic improvement in 99 patients who underwent functional endoscopic sinus surgery from September 1991 through August 1992. The patients were divided into 2-, 4-, 6-, and 12-month postoperative groups. Thickness of the maxillary sinus mucosa measured at the midpoint of the lateral sinus wall on a follow-up ostiomeatal unit computed tomogram (OMU CT) was compared with that of preoperative OMU CT. Postoperative endoscopic findings of the maxillary sinus and changes in presenting symptoms such as rhinorrhea, nasal obstruction, facial pain, headache, anosmia, epiphora, and referred otalgia were analyzed. Improvement in the diseased mucosa of the maxillary sinus, as evaluated on OMU CT, was observed in 69.7% of the patients, and such mucosal changes did not differ significantly among 2-, 4-, 6-, and 12-month follow-up groups. However, apparent mucosal changes exceeding marginal improvement was observed in 32.3% of the patients. The overall symptomatic improvement rate was 57.9% and improvement in endoscopic findings was observed in 46.3% of the patients. Although there was some discrepancy between radiologic and symptomatic improvement rates, symptomatic improvement was significantly related with radiologic improvement. It is suggested that removal of obstructive lesion in the ostiomeatal area might be beneficial in a seemingly early symptomatic improvement, but complete healing of the maxillary sinus mucosa as assessed by OMU CT might take longer than 12 months.
Min
Y G
YG
Department of Otorhinolaryngology, Seoul National University College of Medicine, Korea.
Lee
J W
JW
Shin
J S
JS
D000293:Adolescent; D000328:Adult; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008875:Middle Aged; D009297:Nasal Mucosa / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome