Operating changes in the media wall of the maxillary sinus children

*Lechosław P. Chmielik, Magdalena Frąckiewicz, Mieczysław Chmielik

Summary
Summary
Introduction. The development of diagnostic techniques has allowed us to detect changes which were not noticeable, or were included in a group of more important facts, in the past. . By the sides of the nose, in the classic radical operating method, as well as in cases of severe cancer or a juvenile angiofibroma through a side rhinotomy or Caldwell-Luc method;Roug´a-Denkera method; Moure,a method. Methods of functional endoscopic surgery have been described by Vigand and Stammberger.
Methods. These methods are baased on the use of endoscopes sizes 0, 30, 70 and 120, and the correct set of forceps. In operations on infant sinuses, an especially useful device is a rinsing/suction set, and a microdebrader with a set of angled ends, allowing access to the choden region of the sinuses. The classic route to the maxillary sinus in the FESS operation is to control the sinuses optically. We use a trocar, which is led into the maxillary under inferior turbinated bone. To introduce any additional instruments, it is necessary to make, under the inferior turbinated bone, a flap, using Rettinger´s Method. It is possible to introduce optics and instruments to the maxillary sinuses through a opening ethmoidal infundibulum. When the methods presented above are insufficient, we make a perforation by trocar in the canine fossa, and lead the optics to the maxillary sinuses.
Conclusions. Operations on small patients are greatly eased by the use of the correct instrumentation, but these do not solve all the problemsThe Rettinger´s flap or a opening ethmoidal infundibulum is usually enough to access the median wall of the maxillary sinus.
Acessing the affected area(s) on the median wall of the maxillary sinus is technically difficult

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