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CNAA / Theses / 2008 / June /

Optimization of endoscopic sinus surgery in children with recurrent and chronic rhinosinusitis


Author: Polina Ababii
Degree:doctor of medicine
Speciality: 14.00.04 - Otorhinolaryngology
Year:2008
Scientific adviser: Mihail Maniuc
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 11 June, 2008
Approved by NCAA on the 19 June, 2008

Abstract

Adobe PDF document0.51 Mb / in romanian

Thesis

CZU 616.216-002-036.12-072-053.2

Adobe PDF document 4.57 Mb / in romanian
154 pages


Keywords

Rhinosinusitis chronic and recurrent, acoustic rhinometry, rhinomanometry, nasal endoscopy, computed tomography, anatomic variations, minimally invasive endoscopic sinus surgery

Summary

The work is based on comparative study of results after surgical treatment of 120 children with recurrent and chronic rhinosinusitis in the period 2005 – 2008. All the patients were investigated at the pediatric clinic of the department of otorhinolaryngology of Medical State University „Nicolae Testemiţanu” in the Clinical Republican Hospital for children „Em.Coţaga”. The age of the children ranged between 8 – 17 years old, 59 (49,2%) males and 61(50,8%) females.

In conformity with the method of the treatment all the patients were divided in 3 groups. In the patients of the first group (40 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, sinus maxillary). In the patients of the second group (40 children) the minimally invasive endoscopic sinus surgery was performed. This method proposes the limited approach on ethmoid with vertical resection of processus uncinatus and limited ablation of ostiomeatal complex. In the patients of the third group (40 children) the minimally invasive endoscopic sinus surgery associated with surgery of different anatomic nasal variations (endoscopic septoplasty, submucous resection of concha bullosa) was performed.

The duration of treatment in the patients from the I group was 6,2±0,16 days, in the children from the II group it was 5,33±0,14 days, in the III group it was 4,53±0,12 days, with statistic differences between the groups Р1,2 <0,001, Р1,3 <0,001, Р2,3 <0,001. We considered as recovered those patients who lacked the symptoms of sinusitis for 24 months. The good results were determined in 32 (80%) of the patients in group I, in 36 (90%) of the patients in group II and in 37 (92,5%) in the group III.

Conclusion: the best results were obtained in patients of the third group who have undergone the minimally invasive endoscopic sinus surgery associated with surgery of different anatomic nasal variations.