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Functional endoscopic sinus surgery in children


Author: Mihail Maniuc
Degree:doctor habilitat of medicine
Speciality: 14.00.04 - Otorhinolaryngology
Year:2007
Scientific consultant: Ion Ababii
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 21 February, 2007
Approved by NCAA on the 19 April, 2007

Abstract

Adobe PDF document0.40 Mb / in romanian

Thesis

CZU 616.216–072.1-0532

Adobe PDF document 1.77 Mb / in romanian
228 pages


Keywords

rhinosinusitis recurrent and chronic, nasal endoscopy, acoustic rhinometry, olfactometry, mucociliar clearance, functional endoscopic surgery, minimally invasive endoscopic surgery

Summary

The work is based on comparative study of results after surgical treatment of 420 children with recurrent and chronic rhinosinusitis between 1994 - 2006. All the patients were investigated at the pediatric clinic of the department of otorhinolaryngology of Medical State University “Nicolae Testemitianu” in the Clinical Republican Hospital for children “Em.Cotaga”. The age of the children ranged between 3-15 years old, 275 males (65, 5%) and 145 females (34, 5%).

In conformity with the method of the treatment all the patients were divided in 3 groups, the third group was divided in two subgroups. In the patients of the first group (84 children) the standard endoscopic sinus surgery was performed. This method includes: the relatively large ablation of all the anatomical structures from operation zone (processus uncinatus, ethmoid cells, ostium of sinus maxillary). In the patients of the second group (131 children) the minimally invasive endoscopic sinus surgery was performed. This method proposes the limited approach on ethmoid with inferior resection of processus uncinatus. In the patients of the third group (205 children) the minimally invasive endoscopic sinus surgery of self modification was performed. This modification includes partial vertical resection of processus uncinatus and limited ablation of all the anatomical structures of ostiomeatal complex.

The duration of the treatment in patients from the I group was 6,15±0, 24 days, in the children from the II group it was 5,29±0, 22, on the III group it was 4, 26±0,25 days, with statistic differences between the III group and the II one (t= 6, 12; P<0,001), between the III and the I group (t= 7, 15; P<0,001). The patients were considered recovered if all the symptoms were absent over a period of 36 months. The good results were determined in 73,7% of the patients in group I, in 78,2% of the patients in group II, in 85,7% in the group III.

Conclusion: the best results were obtained in patients who have undergone the minimally invasive endoscopic sinus surgery of self modification.