Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-25T11:30:43.689Z Has data issue: false hasContentIssue false
  • English
  • Français

Fundamental Considerations of Design and Function

Published online by Cambridge University Press:  09 November 2023

Valerie Joan Lund
Valerie Joan Lund*
Affiliation:
Professorial Unit, Institute of Laryngology and Otology, London WC1X 8EE
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The operation of inferior meatal antrostomy has emerged as the most popular surgical technique in the management of maxillary sinusitis though the surgical anatomy and natural history of the procedure are poorly understood. The anatomy of the inferior meatus determines surgical limitations and a retrospective study of 108 patients who have undergone antrostomy provides a oasis for a prospective study in which the size of the antrostomy has been assessed in 65 patients pre- and post-operatively using direct measurement and serial photography. After initial circumferential healing within the first few weeks, the majority remain unchanged unless infection supervenes when complete closure may result. The closure is a combination of fibrous tissue and bone in the majority of cases. A critical size is apparent below which complete closure can be anticipated whereas if too large an antrostomy is fashioned, related anatomy is jeopardised and therefore the dimensions must be carefully judged if long-term patency is desired.

The effect of patency on the mucus-secreting elements of sinus mucosa is examined in a second prospective group of 19 patients. Assessment of subjective clinical success determines overall benefit from the operation in most patients though mucous discharge is least improved and this is directly related to the level of increase in goblet cells.

The role of the inferior meatal antrostomy is dependent upon an understanding of the pathophysiology of sinusitis and thereby determining those patients who have potentially reversible mucosal damage and are therefore most likely to benefit from the procedure.

Type
Inferior Meatal Antrostomy
Information
The Journal of Laryngology & Otology , Volume 102 , Issue S15: Inferior Meatal Anstrostomy: Fundamental Considerations of Design and Function , 1988 , pp. 1 - 18
Copyright
Copyright © JLO (1984) Limited 1988

References

Barlow, R. A. (1921) The value of conservative intranasal drainage for chronic empyema of the antrum. Minnesota Medicine 4: 445Google Scholar
Boies, L. R. (1954) Chronic maxillary sinusitis. Archives of Otolaryngology 59: 36-40CrossRefGoogle ScholarPubMed
Buckley, R. E. (1934) How to obviate failures in the results of paranasal sinus surgery. Laryngoscope 44: 853-856CrossRefGoogle Scholar
Caldwell, G. W. (1893) Diseases of the accessory sinuses of the nose and an improved method of treatment for suppuration of the maxillary antrum. New York Medical Journal 51: 526-528Google Scholar
Canfield, R. B. (1908) The submucous resection of the lateral nasal wall in chronic empyema of antrum, ethmoid and sphenoid. Journal of American Medical Association 51: 1136-1141CrossRefGoogle Scholar
Capps, F. C. W. (1952) Observations on the treatment of infections of the maxillary antrum. Journal of Laryngology and Otology 66: 199-210CrossRefGoogle ScholarPubMed
Claoue, J. (1912) Dix ans de pratique de l'operation de Claoue pour le traitment de la sinusite maxillaire chronique. Archives Internationales de laryngologie d'otologie et de rhinologie, Gazette Lebdomadaine des Sciences Medicales de Bordeaux 33: 355-361Google Scholar
Cook, H. C. (1974) Manual of Histological Demonstration Techniques. pp. 202 Butterworths, LondonGoogle Scholar
Desault, P. J. (1798) Oeuvres chirurgicales ou expose de la doctrine et de la pratique de P.J.Desault. Vol I Maladies des parties molles Chez Meguignon p 142-153Google Scholar
Desault, P. J. (1801) Oeuvres chirurgicales ou expose de la doctrine et de la pratique de P.J.Desault. Vol II p 156-172Google Scholar
Dixon, F. W. (1958) The clinical significance of the anatomical arrangement of the paranasal sinus. Annals of Otology, Rhinology and Laryngology 67: 736-741CrossRefGoogle Scholar
Djindjian, R. and Merland, J. J. (1978) Super-selective arteriography of the external carotid artery. Springer Verlag, Berlin, Heidelberg, New YorkCrossRefGoogle Scholar
Eckert-Mobius, A. (1933) Vergleichend anatomisch-physiologische Studie uber Sinn und Zweck der Nasennebenhohlen des Menschen und der Saugetiere. Archiv für Ohren-Nasen u Kehlkopfheilkunde 134: 287-307CrossRefGoogle Scholar
Ellefsen, P. and Tos, M. (1972) Goblet cells in the human trachea. Quantitative studies of normal trachea. Anatomischer Anzeiger 130: 501-520Google Scholar
Freer, O. T. (1905) The Antrum of Highmore: Removal of the greater part of its inner wall. Laryngoscope 15: 343-349CrossRefGoogle Scholar
Gooch, 1770 Quoted by Cordes, H. (1905) Bitrag zur Behandlung der Chronischen keifleshohleneiterung. Monztschrift Für Ohrenheilkunde 39: 1.Google Scholar
Goodyear, H. (1934) Chronic antrum infection. Archives of Otolaryngology 20: 542-548CrossRefGoogle Scholar
Goodyear, H. (1949) Intranasal surgery of the maxillary sinus. Archives of Otolaryngology 50: 795-804CrossRefGoogle ScholarPubMed
Gray's Anatomy, 1973 (eds) Warwick, R., Williams, P. I., Longman, 35th ednGoogle Scholar
Halle, M. (1923) Die intranasale operation bei eitrigen Erkrankungen der Nebenhöhlen. Archiv für Laryngologie und Rhinologie 29: 73-79Google Scholar
Heath, C. (1889) On empyema of the antrum. Transactions of the Odontological Society of Great Britain from meeting November 4, 1899 22:37Google Scholar
Hempstead, B. (1927) Intranasal surgical treatment of chronic maxillary sinusitis. Archives of Otolaryngology 6: 426-433CrossRefGoogle Scholar
Hempstead, B. (1939) End results of intranasal operation for maxillary sinusitis. Archives of Otolaryngology 30: 711-715CrossRefGoogle Scholar
Hilding, A. C. (1932) The physiology of Drainage of Nasal Mucus. Archives of Otolaryngology, 15: 92-100.CrossRefGoogle Scholar
Hilding, A. C. (1950) Physiologic basis of nasal operations. California Medical Journal 72: 103Google ScholarPubMed
Hunter, J. (1835) Collected Works, (ed) Palmer, Longman, London Vol ii p.77 Royal College of SurgeonsGoogle Scholar
Jansen, A. (1893) Zur Eröffnung der Nebenhohlen der Nase bei Chrauscher Eiterung. Archiv für Laryngologie u Rhinologie 1: 135-157Google Scholar
Jones, R., Baskerville, A. and Reid, L. (1975) Histochemical identification of glycoproteins in pig bronchial epithelium: a) normal and b) hypertrophied from enzootic pneumonia. Journal of Pathology 116: 1-11CrossRefGoogle Scholar
Jourdain, A. L. B. (1767) Recherches sur les differents moyens de traiter les maladies du sinus maxillaire. Journal de Medecine de Paris 27: 52-58Google Scholar
Krause, H. (1887) Instrumente rach Dr Krause. Monztschrift fur Ohrenheilkunde 21: 70Google Scholar
Kuster, E. (1889) Ueber die Grundsätze der Behandlung von Eiterurgen in starvwardigen Hühen, mit besonderer Berucksichtigung der Empyems der Pleura. Deutsche Medizinische Wochenschrift 15: 233-236CrossRefGoogle Scholar
Lasjaunias, P. L. (1981) Craniofacial and Upper Cervical Arteries. Williams and Wilkins, Baltimore, LondonGoogle Scholar
Lavelle, R. J. and Spencer Harrison, M. (1969) Infection of the maxillary sinus: the case for the middle meatal antrostomy. Laryngoscope 1971 81: 90-106Google Scholar
Lichtwitz, L. (1886) Des troubles de la voix articulee dans les affections du voile du palais, de la cavite naso-pharyngienne et des fosses nasales. Quoted in Myerson, M. C. (1932) The natural orifice of the maxillary sunus. Archives of Otolaryngology 15Google Scholar
Link, R. (1968) Neue Gesichtspunkte in der Behandlung der chronischen Kieferhohlenerkrankung bei Kindern. Osterreichischer Oto-Laryngologen-Kongreb 103: 401-403Google Scholar
Lothrop, H. A. (1897) Empyema of the antrum of Highmore: a new operation for the cure of obstinate cases. Boston Medical and Surgical Journal 136: 455-466CrossRefGoogle Scholar
Luc, H. (1897) Une nouvelle methode operatoire pour le cure radicale et rapide de Pempyeme chronique du sinus maxillaire. Archives internationales de laryngologie, d'otologie et de rhinologie 10: 273-285Google Scholar
Macbeth, R. (1968) Caldwell-Luc operation 1952-1966. Archives of Otolaryngology 87: 630-636CrossRefGoogle ScholarPubMed
Mackay, I., Stanley, P. Greenstone, M. Holmes, P. and Cole, P. (1983) A nose clinic: initial results. Journal of Laryngology and Otology 97: 925-931CrossRefGoogle ScholarPubMed
Mann, W. and Beck, C. (1978) Inferior meatal antrostomy in chronic maxillary sinusitis. Archives of Otolaryngology 221: 289-295Google ScholarPubMed
McKenzie, D. (1927) Diseases of the Throat, Nose and Ear. W. Heinemann, LondonGoogle Scholar
Messerklinger, W. (1958) Die Schleimhaut der oberen luftwage im blickfeld neuerer forschung. Archiv Klinische experimented Ohren-Nasen und Kehlkopfheilkunde 173: 1-104CrossRefGoogle Scholar
Mikulicz, J. (1887) Zur operativen Behandlung das Empyens der Highmorshohle. Lagenbeck's Archiv für Klinische Chirurgie 34: 626-634Google Scholar
Moore, P. (1939) Intranasal antrostomy in maxillary sinusitis. Surgical Clinics of North America 19: 1243-1252Google Scholar
Myles, R. C. (1907) The indications for and the advantages of the intra-nasal over the radical operation in the treatment of chronic empyema of the antrum of Highmore and the technique to be employed. Laryngoscope 17: 437-444CrossRefGoogle Scholar
Negus, V. E. (1954) The function of the paranasal sinuses. Acta Otolaryngologica 44: 408CrossRefGoogle ScholarPubMed
Nielsen, K. O. and Bak-Pederson, K. (1984) Mucous-producing elements in the laryngeal mucosa in smokers with cancer of the larynx. Cancer 54: 61-643.0.CO;2-F>CrossRefGoogle ScholarPubMed
Parker, C. A. (1906) A guide to diseases of the nose and throat, and their treatment. E.Arnold, LondonGoogle Scholar
Parker, C. A. and Colledge, L. (1921) A guide to diseases of the nose and throat, and their treatment, 2nd edn E.Arnold, LondonGoogle Scholar
Poulson, J. and Tos, M. (1975) Goblet cells in the developing human nose. Acta Otolaryngologica 80: 434-442CrossRefGoogle Scholar
Rethi, L. (1910) Die Radikaloperation der kieferhohleneiterungen von der Nase. Wiener Klinische Wochenschrift 21: 142-149Google Scholar
Reynolds, W. V. and Brandow, E. C. (1975) Recent advances in microsurgery of the maxillary antrum. Acta Otolaryngologica 80: 161-166 ,CrossRefGoogle ScholarPubMed
Schaeffer, J. P. (1920) The nose, paranasal sinuses, nasolacrimal passageways and olfactory organ in man. Blakiston, PhiladelphiaGoogle Scholar
Schicketanz, H. W. (1959) Indikationen zur kieferhohlenfensterung im unteren Nasengang und deren Ergebnisse. Zeitschrift für Laryngologie, Rhinologie, Otologie u ihre Grenzgebiete 38: 240-249Google Scholar
Sluder, G. (1919) A modified Mikulicz operation whereby the entire lower turbinate is saved in intranasal operations on the Antrum of Highmore with presentation of a patient. Laryngoscope 19: 904-910CrossRefGoogle Scholar
Spicer, S. (1894) The surgical treatment of chronic empyema of the antrum maxillare. British Medical Journal 2: 1359Google Scholar
Stammberger, H. (1986) Endoscopic endonasal surgery - concepts in treatment of recurring rhinosinusitis. Otolaryngology - Head and Neck Surgery 94: 143-156 :CrossRefGoogle ScholarPubMed
Stevenson, W. (1931) Chronic maxillary sinusitis. Archives of Otolaryngology 13: 506-531CrossRefGoogle Scholar
Sturmann, , (1908) Zur intranasalen Eröffnung der kieferhöhle. Berliner Laryngologie Gesellschaft Verhandlungen 12: 6-19Google Scholar
Tarkkanen, J., Holopainen, E. and Kohonen, A. (1969) Intranasal antrostomy for chronic maxillary sinusitis. The Eye, Ear, Nose and Throat Monthly 48: 247-250Google ScholarPubMed
Terrahe, K. (1970) Die drüsen der respiratorischen nasenschleimhaut. Gustav Fischer Verlag, StuttgartGoogle Scholar
Thomson, St.Clair (1926) Diseases of the Nose and Throat. 3rd edn. Appleton, LondonGoogle Scholar
Tos, M. and Mogensen, C. (1979) Mucus production in the nasal sinuses. Acta Otolaryngolica. Supplement 360: 131-134Google ScholarPubMed
Tucker, J. C. (1928) Conservative surgical management of chronic maxillary sinusitis. Annals of Otolaryngology 37: 631-633Google Scholar
Unterberger, S. (1932) Konservative Keiferhohlenoperation und Zahne. Zeitschrift für Laryngologie Bd 22 H5-6: 466-475Google Scholar
Vacher, L. (1910) Contribution à l'etude de la cure de la sinusite maxillaire par voie nasale. Annales du maladies de I'oreille du larynx 35: 418-423Google Scholar
Van Alyea, O. E. (1951) Nasal sinuses: an anatomic and clinical consideration. The Williams & Wilkins Co, Baltimore, USAGoogle Scholar
Watson, W. S. (1875) Diseases of the Nose and its Accessory Cavities, LondonGoogle Scholar
Wigand, M. E. and Steiner, W. (1977) Endonasle Kieferhohlenoperation mit endoskopischer Kontrolle Archiv für Laryngologie u Rhinologie 56: 421-425Google Scholar
Wilson, R., Sykes, D. A., Currie, D. C. and Cole, P. J. (1986) Beat frequency of cilia from sites of purulent infection. Thorax 41: 453-458CrossRefGoogle ScholarPubMed
Wood Jones, F. (1939) The anterior superior alveolar nerve and vessels. Journal of Anatomy (London) 73: 583-591Google Scholar
Zuckerkandl, E. (1893) Normale und pathologische Anatomie der Nasenhöhle und interpneumatischen Anhünge. W Braumuller, LeipzigGoogle Scholar