engleski

Endoscopic monitoring of postoperative sinonasal mucosa wounds healing after FESS.

The sinus labyrinth spaces and ostia of various sinus areas can be visualized by use of endoscopic techniques, e.g., in functional endoscopic sinus surgery (FESS). Ventilation and normal sinus function can be maintained by this minimally invasive method. Endoscopic sinus surgery (ESS) in the superior surgical method of treatment for recurrent acute sinusitis, chronic sinusitis, obstructive nasal polyposis, extramucous fungal sinusitis, periorbital abscess, rhinoliquorrhea, antrochoanal polyp, foreign body extraction, mucocele, dacryocystorhinostomy, excision of various tumors of the sinuses, nose, anterior, middle and posterior cranial fossa, epistaxis control, optic nerve decompression, choanal atresia, and orbit decompression. FESS, a minimally invasive technique, remains the most widely accepted therapy for chronic rhinosinusitis (CRS) and nasal polyposis (NP)after failure of medical treatment. FESS aims to remove inflammatory mucosa and to restore both ventilation and drainage of the sinus cavities. However, healing quality significantly influences the functional outcome. The exact mechanism of mucosal healing after sinus operation remains unclear. Postoperative wound healing is a highly coordinated process that includes coagulation, i.e. clot formation, inflammatory stage, and tissue formation and remodeling. Endoscopic observation of the nasal and sinus mucosa healing after FESS revealed four clinical stages: stage 1 characterized by the formation of abundant crusts for 1-10 days ; stage 2 characterized by obstructive lymphedema, with pronounced swelling of residual mucosa, lasting for up to 30 days ; stage 3 characterized by mesenchymal growth, when pale, edamatous mucosa is transformated to red mucosa, lasting for up to 3 months ; and stage 4 characterized by cicatrix formation, lasting for 3-6 months. The duration of particular stages can be reduced of prolonged by postoperative treatment. Proper treatment of postoperative cavity is a significant segment in the process of mucosal healing, and this part of the FESS. Due knowledge of the healing stages can help recognize a mucosal healing impairment and introduce appropriate therapy depending on the stage of the healing process. The healing stages and planning of postoperative therapy after endoscopic sinus surgery are presented.

Endoscopic sinus surgery ; healing stages

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