Sinusite Crônica Maxilar Cirurgia Endoscópica / Maxilary Chronic Sinusitis Surgery on Silent Sinus

Esse vídeo mostra a abordagem endoscópica para o tratamento de Sinusite ou Rinossinusite Crônica do Seio Maxilar.
Esse seio acometido, é também seio ´ hipoplásico ´, ou seja ele teve o seu desenvolvimento significativamente menor em comparaçâo ao seio maxilar do lado esquerdo desse paciente.
A anatomia do seio maxilar hipoplásico é ligeiramente diferente. E pode ele não apresenta nenhuma comunicação com o nariz, como um seio sadio.
Durante o vídeo é possivel perceber que a parede do seio se apresenta côncava perante o corneto médio. O corneto médio quando rebatido e, posteriormente abordado em turbinoplastia média – remoção parcial da porçao meatal do corneto – afim de aumentar o espaço para realizar o acesso ao seio, permite melhor visualização parede côncava do seio ´ vedada ´ completamente pela mucosa do antro maxilar.
Esse ´ vedamento ´ faz com que o seio não seja ventilado.
Como resultado vemos a grande quantidade de secreção purulenta e pólipos no interior do seio hipoplásico, que foram aspirados e lavados, após sua abertura.
O seio hipoplásico impõe alguns cuidados e minúcia técnica além conhecimento anatômico seguro, pois o Olho está mais ´ rebaixado ´ do que o normal, aumentando o risco de uma lesão orbitária.
Alguns pacientes com hipoplasia ou até atresia (ausencia do seio) podem apresentar assimetria facial e interocular, com o olho do lado hipoplásico visualmente mais rebaixado em referencia ao olho contralateral.
A hipoplasia do seio maxilar pode não causar sintoma algum, mas neste caso estava totalmente obliterado.
Quando realizado o procedimento de antrostomia maxilar ou sinusotomia maxilar de maneira correta, o paciente fica livre de sintomas, muitas vezes definitivamente.
Neste caso se o sintomas se pronunciava como dor intensa e constante com piora durante variações bruscas de temperatura ou pressão atmosférica.
Durante essa cirurgia foi procedida a Septoplastia endoscópica e as turbinoplastias afim de melhorar a permeabilidade sinus.
Essa cirurgia durou cerca de 3 horas e meia, e na sala de recuperação o paciente já sentiu um alívio e conforto respiratório que jamais havia experimentado.
Dr. Reinaldo Cóser Neto
______________________________________________________
This video clip demonstrates to the endoscopic technique for the therapy of a Maxilary Persistent Sinusitis.
Right here we demonstrate to an maxillary sinus hipoplasia, or "Silent Sinus".
The anatomy is a little various, as well as has no communication with the nose cavity, in this particular case.
During the video it is feasible to recognize that the sinus wall surface shows up concave, rigth after removing the section of the meatus center turbinate.
This 'sealing' happens to stay clear of the essential ventilation of the sinus.
Consequently we see a big quantity thick purulent secretion and polyps within the sinus hypoplasia, which were suctioned and also cleaned after its opening.
This situation calls for some added care as well as fine-tuned technical as well as physiological understanding as teh eye is much sag the teh usual.
Some clients with hypoplasia or even atresia (lack of the sinus) could have facial asymmetry as well as interocular imbalance.
Hypoplasia of the maxillary sinus could not trigger any type of symptoms, yet in this case was entirely obliterated.
Continued the maxillary antrostomy surgical procedure or sinusotomy the person did not hesitate of signs and symptoms right in the recuperation room!
During this surgery was done the endoscopic septoplasty and turbinoplasties order to boost nasal patency.
This surgery lasted around 3 hrs, no have to stay in healthcare facility.

Reinaldo Cóser Neto, ENT M.D.

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