[The role of computed tomography after functional surgery on the paranasal sinuses. Normal findings and an assessment of the surgical failures].
BACKGROUND
Functional endoscopic sinus surgery has become the technique of choice to treat benign or inflammatory diseases of paranasal sinuses resistant to medical therapy. The goal of this type of surgery is to open the obstructed sinus ostia and restore normal aeration and mucociliary clearance. Messerklinger's is the most widely used technique.


OBJECTIVE
We investigated the role of CT after functional endoscopic sinus surgery and describe CT findings of postoperative anatomical changes together with frequent complications and surgical failures.


METHODS
Twenty-seven patients with relapsing symptoms were examined with CT of paranasal sinuses 8-32 weeks after functional endoscopic sinus surgery. In all cases both preoperative CT and surgical reports were available: CT and surgical results were compared.


RESULTS
In 21/27 patients nasosinusal changes were demonstrated with CT. Recurrent disease secondary to inflammation and/or fibrosis was observed in 14 cases. Residual disease was seen in 5 patients. A major orbital complication was found in 1 patient with diplopia. One patient exhibited a large interruption of cribriform plate with CSF fistula.


CONCLUSIONS
CT permitted an accurate assessment of extension and results of functional endoscopic sinus surgery. CT is indicated in the postoperative study of the patients who a) present symptoms of cerebral and ocular complications (early after functional endoscopic sinus surgery); and b) do not respond to medical treatments 8-32 weeks after unsuccessful functional endoscopic sinus surgery. In these patients CT can demonstrate recurrent and/or residual nasosinusal disease and bony defects unintentionally caused by the surgeon during the procedure.
Scribano
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Istituto di Scienze Radiologiche, Università, Messina.
Ascenti
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Cascio
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Bellinvia
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Mazziotti
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Lamberto
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D004724:Endoscopy; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D010255:Paranasal Sinus Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging* / Q000601:surgery; D011127:Polyps / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012008:Recurrence; D012189:Retrospective Studies; D012852:Sinusitis / Q000000981:diagnostic imaging / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure
Ruolo della tomografia computerizzata dopo chirurgia funzionale dei seni paranasali. Rilievi normali e valutazione degli insuccessi chirurgici.