Researchers did this study to compare the effectiveness of cadaveric nasal irrigation distribution and force following different surgical techniques commonly used to open the maxillary sinus.
The researchers dissected fresh human cadaver heads sequentially with uncinectomy, maxillary antrostomy, endoscopic maxillary mega-antrostomy, and modified endoscopic medial maxillectomy. Afterward, they performed each surgical technique; the corresponding nasal cavity was rinsed with 240 mL irrigation bottles containing 1/1000 10% fluorescein-labeled free water. A nasal endoscope passed through the canine fossa into a fixed position in the maxillary sinus recorded the extent of sinus irrigation. These videos then underwent blinded assessment by two observers assessing for irrigation sinus penetration and force. Ordinal correlation scores were evaluated using Kendall’s tau-B.
Researchers assessed a total of seventeen sinuses. There was a statistically significant positive correlation between the increasing extent of maxillary sinus dissection and both sinus penetration and force considered by both observers.
The study concluded that increasing the extent of surgical dissection improves penetration and force of the nasal irrigation into the maxillary sinus. Findings suggest that while a standard maxillary antrostomy may be sufficient to achieve fair topical therapy distribution.