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Article Type

Article

Abstract

Background and Objectives: Functional endoscopic sinus surgery (FESS) is based mainly upon the intervention with the middle meatus. As it is wellestablished that the almost of the paranasal sinus groups are draining into middle meatus therefore the outcomes of FESS are depending mainly upon the postoperative maintenance of middle meatal patency. Although there are many clinical trials which described to achieve the sufficient patency of middle meatus after FESS but after performance of these established modalities the outcomes for some extent are still not satisfied therefore the idea of gel-film application at the interfered middle meatus was introduced and studied via this serial study just to confirm its effectiveness regarding maintenance of middle meatal patency as compared to middle meatal packing after FESS.
Patients and Methods: 105 patients aged 13-63 years of chronic sinusitis, presented with clinical as well as radiological evidences of solitary maxillary sinusitis, and maxillo-ethmoidal sinusitis with or without frontal and sphenoidal involvement at ENT OPD –Al-tarahom private center Elbyda city- Libya at period in between July 2013 to January 2017 who operated by FESS, and the patients divided into two groups; group-A (n=25 ) and group-B (n=80), which include those patients who proceeded after middle meatal endoscopic surgery by the middle meatal gel-films application and middle meatal packing consecutively. The two groups were compared in relation to post-operative patency persistence of ipsilateral middle meatus and correlated to the incidence of sinusitis recurrence after the surgery.
Results and Conclusion: Around 49% of the patients who underwent just medialization of ipsilateral middle turbinate followed by middle meatal packing developed recurrence of sinusitis due to re-obliteration of middle meatus either by synechia between middle turbinate and lateral wall or by extreme lateralization of the middle turbinate as compared to the other group among which one patient (4%) got evidences of recurrence of sinusitis due to re-obliteration of middle meatus by synechia between ipsilateral middle turbinate and opposite lateral wall after approximately one year of follow up. Thus we can conclude to that the gel-films application at middle meatus after middle meatal endoscopic surgery maintains significantly the postoperative middle meatal patency as compared to middle meatal packing.
Keywords: Middle meatal packing, middle meatal gel-film application, and middle meatal patency.

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