Place of Middle Meatotomy in the Management of Rhinologic Chronic Sinusitis

##plugins.themes.bootstrap3.article.main##

  •   Ginnot B. Andriamampionona

  •   M. R. Razafimandimby

  •   A. D. Rabarijaona

  •   A. H. N. Rakotoarisoa

Abstract

Introduction: Middle meatotomy is an effective surgical technique in the management of chronic sinusitis rebels to medical treatment. It is an optimal therapeutic option in the face of a chronic sinusitis particularly of rhinological origin.


Patients and method: It is a descriptive retrospective study over an 11-year period from January 2009 to December 2019 at the service of Otolaryngology and Cervico-facial surgery (ORL-CCF) at the Andohatapenaka University Hospital Antananarivo Madagascar. Our study includes subjects who have benefited from an average meatotomy on chronic sinusitis.


Results: We collected 320 patients of average age of 33.78 years. Repetitive maxillary sinusitis and rhinogenic allergies are the determinants of chronic sinusitis. Nasal obstruction was the constant functional sign and anterior rhinoscopy revealed a red nasal mucosa with enlarged inferior turbinate. All of our patients received an incidence X-ray of Blondeau. The average meatotomy was achieved in all our patients and among them, a proportion of 12.50% of the cases operated at the same time of a medium meatotomy and opening of other meatus. Complementary turbinal surgery was used in 25% of cases.


Therapeutic efficacy was assessed subjectively by the subject’s functional signs. Favourable trends were reported in 75.30% of cases.


Conclusion: Chronic sinusitis is a naso-sinus condition requiring medical-surgical management. The middle meatotomy is the first step in the surgical management of chronic rhinological sinusitis rebellious to medical means.


Keywords: Chronic, meatotomy, sinusitis

References

Deconde AS, Soler Z M. Chronic Rhinosinusitis: Epidemiology and burden of disease. American Journal of Rhinology and Allergy.2016; 30(2): 134-9.

Lechien J, Mahillon V, Boutremans E, Loeb I, Kampouridis S, Chantrain G et al. Rhinosinusites chroniques maxillaires d’origine dentaire: à propos de 2 cas. Rev Med Brux.2011; 32: 98-101.

Beule A. Epidemiology of chronic rhinosinisitis, selected risk, factors, comorbidities and economic burden. Laryngo-Rhino-Otologie.2015; 94(1): 1-23.

Hastan D, Fokkens W, Bachert C, Newson R, Bislimovska J, Bockelbrink A et al. Chronic rhinosinusitis in Europe – an underestimated disease. A GA (2) LEN study. Allergy. 2011; 66(9):1216–23.

Gamra O, Jebali N, Dhambri S, Abid W, Zribi S,Hariga I et al.Meatotomie moyenne : indications et resultats. Journal Tunisien d’ORL Chir Cervico-Faciale.2013; 30: 57-60.

Ouedraogo R-WL, Ouattara M, Ouedraogo BP, Gyebre YM, Sanou SM, Sereme M et al. Les sinusites chroniques de la face dans le Service d’ORL du CHU de Yalgaldo Ouedraogo de Ouagadogou à propos de 365 cas. Rev Cames Santé. 2013; 1: 1-5.

Traore M. Etude des sinusites maxillaires au Centre Hospitalier Universitaire d’Odontostomatologie de Bamako [Thèse].Médécine Humaine: Bamako; 2010; 101 p.

Gold S, Tami T. Role of middle meatus aspiration culture in the diagnosis of chronic sinusitis, American Journal of Rhinology. 1998; 12(2): 151.

AFSSAPS. Recommandations: pratique clinique des rhinosinusites aigues de l’adulte et de l’enfant argumentaire.TL RSIA def SFRORL.2005: 06-68.

Zahir I. La méatotomie moyenne dans le traitement des sinusites chroniques à-propos de 55cas [Thèse]. Médecine Humaine: Meknès; 2018; 114 p.

Bonds RS,Midoro-Horiuti T, Estrogen effects in allergy and asthma. Current Opinion in Allergy and Clinical Immunology. 2013; 13(1): 92-99.

Vacher C. Bases anatomiques de l’abord du sinus maxillaire pour l’implantologie. Actual Odontostomatol (Paris). 2013; 265: 19-23.

Njifou Njimah A, Ndongo BL, Kuiffo C, Mpessa EM, Moho A, Minka E et al. Les Rhinosinusites Chroniques à l’ Hôpital Laquintinie de Douala Chronic rhinosinusitis in Douala Laquintinie Hospital. Heal. Sci. Dis.2018; 19: 99-103.

Zojaji R, Mirzadeh M, Naghibi S. Comparative Evaluation of Preoperative CT Scan and Intraoperative Endoscopic Sinus Surgery Findings in Patients with Chronic Rhinosinusitis Rhinosinusitis.2008; 5(2): 77-82.

Boroma S. Complications des sinusites en milieu hospitalier (aspects épidémiologiques,cliniques et évolutifs de 125 cas hospitalisés) dans le service d'ORL du centre hospitalier national Yalgado Ouédraogo (CHNYO) de Ouagadougou de 1992 à 1996.[Thèse].Médecine Humaine :Ouagadougou; 1998: 124 p.

Dao S. Etude Epidemioclinique et Therapeutique Des Rhinosinusites Aigues et Chroniques au Centre Hosptalier Universitaire du Gabriel Touré[Thèse]. Médecine Humaine: Bamako; 2014: 128 p.

Percordani J, Serrano E. Explorations cliniques et fonctionnelles des fosses nasales. Rev Mal Respir.2002; 19: 655-7.

Eloy P, Watele JB, Rombaux P, Daele J, Bertrand B. Management of chronic rhinosinusitis without polyps in adults. B-ENT.2005; 1: 65–76.

Ferrié JC, Klossek JM. L’imagerie des sinus de la face et du massif facial: stratégies d’exploration. J Radio Éditions françaises de radiologie Paris.2003; 84: 963-967.

Gilain L, Laurent S. Sinusites maxillaires. EMC-oto-rhino-larynologie.2000; 2(2): 160-173.

Pasquier M, Maudet L. Recommandation pour la pratique clinique Rhinosinusite infectieuses aigues. Société Francaise d’Oto-Rhino- Laryngologie et de Chirurgie de la Face et du Cou. 2017: 2-3.

Ivor AE, Shah SB. Chronic rhinosinusitis: Allergy and sinus computed tomography relationships. Otolaryngol. – Head Neck Surg.2000; 123(6): 687-691.

Davis WE, Templer JW, Lamear WR. Patency Rate of Endoscopic Middle Meatus Antrostomy. Otolaryngol. Neck Surg.1991;101: 416–420.

Davis WE, Templer JW, Lamear WR, Craig SB. Middle Meatus Anstrostomy: Patency Rates and Risk Factors.Otolaryngol. Neck Surg.1991 ;104(4): 467–472.

Leneveu C, Coste A, Zerah F, Billebaud T, Prulière-escabasse V, De kermadec P H et al. Méatotomie moyenne en ambulatoire: une pratique à risque? Sphenoidotomie par voie transnasale transostiale: à propos de 86 cas avec atteinte sphenoidale isolee Dilatation par ballonet du rece. Ann. françaises d’oto-rhino-laryngologie Pathol. cervico-faciale, 2014; 131(4): A75-A103.

Roithmann R. Inferior turbinectomy: what is the best technique? Braz. J. Otorhinolaryngol. 2018; 1-6.

Facon F, Dessi P. Chirurgie endonasale micro-invasive: apport de l’endoscopie en chirurgie maxillo-faciale. Rev. Stomatol. Chir. Maxillofac. 2005; 106(4): 230–242.

Kamel RH. Endoscopic transnasal surgery in chronic maxillary sinusitis. J. Laryngol. Otol.1989;103(5):492-501.

Stankiewicz JA. Complications of Endoscopic Nasal Surgery: Occurrence and Treatment. Am. J. Rhinol. 2007; 1(1): 45-49.

##plugins.themes.bootstrap3.article.details##

How to Cite
Andriamampionona, G. B., Razafimandimby, M. R., Rabarijaona, A. D., & Rakotoarisoa, A. H. N. (2021). Place of Middle Meatotomy in the Management of Rhinologic Chronic Sinusitis. European Journal of Clinical Medicine, 2(3), 30–33. https://doi.org/10.24018/clinicmed.2021.2.3.76