DOI: 10.36347/sjams.2019.v07i12.038

Pages: 4016-4021

Impairment of normal ventilation and drainage pathways results in various types of sinus pathology. Endoscopic middle meatal antrostomy aims at restoring the ventilation and re-establishing the mucociliary drainage of the maxillary sinus. There has been much debate over the years regarding the optimum size and design of middle meatal antrostomy, its long term patency and relationship with symptomatic improvement of the maxillary sinus pathology. This prospective observational study was conducted in the department of the E.N.T and Head-Neck Surgery of a tertiary care teaching hospital with the objectives of 1) evaluating the long term patency of endoscopic middle meatal antrostomy in maxillary sinus pathology, 2) correlating the size of antrostomy and symptomatic improvement in the post-operative period. Fifty patients undergoing middle meatal antrostomy for isolated inflammatory pathology of the maxillary sinus were studied prospectively for a period of two years. In each patient, the size of antrostomy was recorded by measuring gauze during surgery and in the postoperative period (3rd and 6th month). In the same sitting, the degree of improvement of their symptoms was assessed based on visual analogue scale (VAS). There was statistically significant (p<0.001) reduction of both vertical and horizontal lengths of the middle meatal antrostomy (36% and 35% respectively) from the base line (per-operative size). Postoperative symptomatic improvement of maxillary sinus diseases corroborated to the size of the antrostomy at the end of 6 months. This was also statistically significant (p<0.05). The antrostomy opening, made at surgery, reduces in size over time. Lesser the reduction of the size of the antrostomy opening, greater the degree of improvements of symptoms.