Title: Evaluation of Role of Minimally Invasive Sinus Technique (MIST) in patients of Chronic Rhinosinusitis
Authors: Naveen Agrawal, H.S. Sharma, Pulkit Khandelwal, Varsha Raghuvanshi, Mohit Samadhiya, Anand Sharma
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.50
Abstract
Background: MIST is stepwise intranasal intervention with defined beginning and end for all patients regardless of disease severity, there by standardizing the procedure for surgeons and patients alike. In the present study the role of minimal invasive sinus technique is evaluated in terms of both a surgical modality of choice and patients satisfaction. This study is done to assess the indications, techniques, results of MIST, And to assess the efficacy and reliability of MIST.
Material and Method: This prospective study is conducted in the department of otorhinolaryngology, Index Medical College Hospital and Research Centre, Indore from Sep 2014 to Sep 2016. A total of 60 patients (age ranged from 9 years to 50 years) having nasal and sinus complaints were selected. Detailed Clinical evaluation, preoperative diagnostic nasal endoscopy, CT Para-nasal sinus was done and MIST was performed in all cases. Post-operative subjective improvement was assessed.
Result: The main symptoms in the study group was nasal obstruction followed by nasal discharge. On anterior rhinoscopic examination DNS was seen followed by ITH. Pre-operative nasal endoscopy showed MPD in OMC followed by MPD in ET, polyp was also seen in cases. The most striking anatomical variants seen after pre-operative nasal endoscopy was swollen agger nasi cells followed by Overpnuematized bulla, medially bent U.P, laterally bent U.P, polyploid U.P and paradoxically bent M.T. these findings were confirmed on CT PNS. Various surgical procedures were performed including uncinectomy followed by CB exteriorization, opening of bulla, anterior ethmoidectomy, posterior ethmoidectomy and sphenoidectomy. Post-operative subjective improvement was assessed in every patient. No major post-operative complication occurred in this study.
Conclusion: Our study shows that MIST is a safe and effective method of treatment in cases of Chronic Rhino-sinusitis in all age group of patients , by providing better understanding of sinus pathophysiology and opens the new horizons of treating them with minimal injury to the surrounding normal mucosa.
Keywords: MIST, CHRONIC RHINOSINUSITIS, FESS.
