A Comparative Study of Two Different Uncinectomy Techniques: Swing-Door and Classical

Message:
Abstract:
Introduction
The aim of this study was to determine which technique of uncinectomy is better classical or swing door technique. It is a prospective study in which 480 cases of uncinectomies were performed by two different techniques and outcomes studied.
Materials And Methods
Cases of sinusitis were selected and operated for Functional Endoscopic Sinus Surgery (FESS). Out of these, in 240 uncinectomies classical uncinectomy was done whereas in another 240 uncinectomies swing door technique was used. Initially patients were medically managed according to their symptoms and prior management. Patients who had received previous adequate medical management were evaluated with CT scan of the sinuses. If disease still persists than they were operated for FESS.
Results
The author's experience indicates that Functional endoscopic sinus surgery can be performed under local or general anesthesia, as permitted or tolerated. In this review classical technique was used in 240 uncinectomies. Out of this, ethmoidal complex injury was noted in 4 cases, missed maxillary ostium syndrome (incomplete removal) was reported in 12 patients and orbital fat exposure was encountered in 5 patients. As compared to 240 uncinectomies done with swing door technique, incomplete removal was evident in 2 cases and lacrimal duct injury was reported in 3 cases. 'Evidence that underscores how this 'swing door technique' successfully combines 'the conservation goals of the AP approach and anatomic virtues of the PA approach to ethmoidectomy of the total 480 uncinectomies operated. Out of which 240 uncinectomies have been performed using the 'swing-door' technique. The 240 uncinectomies performed using classical technique were used as controls. The incidence of orbital penetration, incomplete removal, ethmoidal complex injury and ostium non-identification was significantly less with the new technique. Three lacrimal injuries occurred with the 'swing-door' technique compared to zero injury with classical technique.
Conclusion
The authors recommend swing door technique as it is easy to learn, allows complete removal of the uncinate flush with the lateral nasal wall and allows easy identification of the natural ostium of the maxillary sinus without injuring the ethmoidal complex.
Language:
English
Published:
Iranian Journal of Otorhinolaryngology, Volume:24 Issue: 2, Spring-2012
Page:
63
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