Surgical field visualization in patients with polyposis rhinosinusitis
Introduction. Patients with nasal polyposis are predisposed to diffuse intraoperative bleeding, that could highly impair surgical field visualization. The absence of a universal technique of improving surgical field visualization became a reason for searching the specific hemostatic methods.Objectiv...
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| Format: | Article |
| Language: | Russian |
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Remedium Group LLC
2021-05-01
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| Series: | Медицинский совет |
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| Online Access: | https://www.med-sovet.pro/jour/article/view/6170 |
| _version_ | 1797841306383286272 |
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| author | H. B. Bebchuk N. A. Daikhes V. M. Averbukh M. Z. Dzhafarova T. I. Garashchenko O. V. Karneeva I. V. Koshel |
| author_facet | H. B. Bebchuk N. A. Daikhes V. M. Averbukh M. Z. Dzhafarova T. I. Garashchenko O. V. Karneeva I. V. Koshel |
| author_sort | H. B. Bebchuk |
| collection | DOAJ |
| description | Introduction. Patients with nasal polyposis are predisposed to diffuse intraoperative bleeding, that could highly impair surgical field visualization. The absence of a universal technique of improving surgical field visualization became a reason for searching the specific hemostatic methods.Objective: to evaluate the efficiency of sphenopalatine artery and/or its branches coagulation as a method of hemostasis in endoscopic surgery for nasal polyposis and to describe the surgical anatomy of sphenopalatine artery.Materials and methods. Endoscopic coagulation of sphenopalatine artery and/or its branches was performed among 30 patients with nasal polyposis. Surgical field visualization was graded by Boezaart and Wormald scales before and after coagulation.Results and discussion. Intraoperative attempts to achieve the hemostasis using warm (490С) saline irrigation and then application of xylometazoline (0.1%-10ml) and lidocaine (10%-4ml) were ineffective among 28 patients with initial grade 8 and among 2 patients with grade 9 according to Wormald scale. Sphenopalatine artery and/or its branches coagulation was effectively performed in these patients, obtaining the hemostasis in 100% of cases (р < 0,001). The initial surgical field grade improved to grade 5 by Wormald scale in 9 patients (30%), to grade 6 in 17 patients (56,7%) and to grade 7 in 4 patients (13,3%). Only one artery (trunk of sphenopalatine artery) was observed in 18 patients (60%), crossing the sphenopalatine foramen, and 2 arteries (posterior septal artery and posterior lateral nasal artery) – in 12 patients (40%). Endoscopic examination revealed no signs of mucosal atrophy in postoperative period.Conclusion: The appropriate choice of hemostatic technique depends on grades of surgical field visualization. If there is a grade 8–9 by Wormald scale, endoscopic coagulation of sphenopalatine artery and/or its branches is an effective and safe method to improve surgical field visualization. |
| first_indexed | 2024-04-09T16:28:55Z |
| format | Article |
| id | doaj.art-b01865507d904f87af45884a4dd76b2a |
| institution | Directory Open Access Journal |
| issn | 2079-701X 2658-5790 |
| language | Russian |
| last_indexed | 2024-04-09T16:28:55Z |
| publishDate | 2021-05-01 |
| publisher | Remedium Group LLC |
| record_format | Article |
| series | Медицинский совет |
| spelling | doaj.art-b01865507d904f87af45884a4dd76b2a2023-04-23T06:57:12ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902021-05-010610611210.21518/2079-701X-2021-6-106-1125599Surgical field visualization in patients with polyposis rhinosinusitisH. B. Bebchuk0N. A. Daikhes1V. M. Averbukh2M. Z. Dzhafarova3T. I. Garashchenko4O. V. Karneeva5I. V. Koshel6National Medical Research Center of OtorhinolaryngologyNational Medical Research Center of OtorhinolaryngologyNational Medical Research Center of OtorhinolaryngologyNational Medical Research Center of OtorhinolaryngologyNational Medical Research Center of OtorhinolaryngologyNational Medical Research Center of OtorhinolaryngologyStavropol State Medical UniversityIntroduction. Patients with nasal polyposis are predisposed to diffuse intraoperative bleeding, that could highly impair surgical field visualization. The absence of a universal technique of improving surgical field visualization became a reason for searching the specific hemostatic methods.Objective: to evaluate the efficiency of sphenopalatine artery and/or its branches coagulation as a method of hemostasis in endoscopic surgery for nasal polyposis and to describe the surgical anatomy of sphenopalatine artery.Materials and methods. Endoscopic coagulation of sphenopalatine artery and/or its branches was performed among 30 patients with nasal polyposis. Surgical field visualization was graded by Boezaart and Wormald scales before and after coagulation.Results and discussion. Intraoperative attempts to achieve the hemostasis using warm (490С) saline irrigation and then application of xylometazoline (0.1%-10ml) and lidocaine (10%-4ml) were ineffective among 28 patients with initial grade 8 and among 2 patients with grade 9 according to Wormald scale. Sphenopalatine artery and/or its branches coagulation was effectively performed in these patients, obtaining the hemostasis in 100% of cases (р < 0,001). The initial surgical field grade improved to grade 5 by Wormald scale in 9 patients (30%), to grade 6 in 17 patients (56,7%) and to grade 7 in 4 patients (13,3%). Only one artery (trunk of sphenopalatine artery) was observed in 18 patients (60%), crossing the sphenopalatine foramen, and 2 arteries (posterior septal artery and posterior lateral nasal artery) – in 12 patients (40%). Endoscopic examination revealed no signs of mucosal atrophy in postoperative period.Conclusion: The appropriate choice of hemostatic technique depends on grades of surgical field visualization. If there is a grade 8–9 by Wormald scale, endoscopic coagulation of sphenopalatine artery and/or its branches is an effective and safe method to improve surgical field visualization.https://www.med-sovet.pro/jour/article/view/6170chronic rhinosinusitis with nasal polypsendoscopic sinus surgerybleedingsurgical field visualizationhemostasissphenopalatine artery |
| spellingShingle | H. B. Bebchuk N. A. Daikhes V. M. Averbukh M. Z. Dzhafarova T. I. Garashchenko O. V. Karneeva I. V. Koshel Surgical field visualization in patients with polyposis rhinosinusitis Медицинский совет chronic rhinosinusitis with nasal polyps endoscopic sinus surgery bleeding surgical field visualization hemostasis sphenopalatine artery |
| title | Surgical field visualization in patients with polyposis rhinosinusitis |
| title_full | Surgical field visualization in patients with polyposis rhinosinusitis |
| title_fullStr | Surgical field visualization in patients with polyposis rhinosinusitis |
| title_full_unstemmed | Surgical field visualization in patients with polyposis rhinosinusitis |
| title_short | Surgical field visualization in patients with polyposis rhinosinusitis |
| title_sort | surgical field visualization in patients with polyposis rhinosinusitis |
| topic | chronic rhinosinusitis with nasal polyps endoscopic sinus surgery bleeding surgical field visualization hemostasis sphenopalatine artery |
| url | https://www.med-sovet.pro/jour/article/view/6170 |
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