The importance of therapeutic management in chronic maxillary sinusitis

Introduction Chronic maxillary sinusitis (CMS) in adults is a significant problem of the health problem due to its frequency. By symptomatology of CMS affects the quality of life and the costs of public health care are growing up. The aim is to present 53 cases with CMS with allergic etiology and their therapeutic management.

Material and Methods The diagnosis of all cases was based on typical signs and symptoms, X-ray examination, CT scan of paranasal sinuses, nasal endoscopy and skin-prick tests or RAST to confirm the allergic elements of chronic symptoms. The drug treatment (antibiotics, oral antihistamines, intranasal steroids and nasal decongestants) gave very good Results in 26 cases. The surgery was applied in all cases with CMS nonresponsive to medical treatment. In 12 cases we performed endoscopic sinus surgery (ESS) via the canine fossa. External surgical approach Caldwell-Luc procedure was performed in the rest 15 cases.

Results Follow-up ranged from 1 to 3 years with a median of 2.5 years. The external procedure removes the affected mucosa with purpose a new healthy mucosa to regrow. Endoscopic sinus surgery revealed no recurrence. Allergic CMS has a good prognosis after surgery and post-operative steroid treatment. The long term used topical steroids helps against relapses and required a prolonged follow up.

Conclusion The therapeutic management of CMS included drug treatment, external approach or combined endoscopic procedures in order to ensure best Results. Endoscopic sinus surgery is the gold standard therapy for CMS non-responsive to conservative treatment.

Publication History

Article published online:
10 June 2020