Title: A Comparative Study of Swing-Door and Classical Uncinectomy Technique
Authors: Naveen Agrawal, Vishal Hansrajani, Mohit Samadhiya, Pulkit Khandelwal, Varsha Raghuwanshi
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.174
Abstract
Introduction: The aim of this study was to compare the technique of uncinectomy, classical and swing door technique.
Materials and Methods: Two hundred Cases of sinusitis were selected and operated for Functional Endoscopic Sinus Surgery (FESS). Out of these, in 100 uncinectomies classical uncinectomy was done whereas in another 100 uncinectomies swing door technique was used. Initially patients were medically managed treated 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: Functional endoscopic sinus surgery can be performed under local or general anesthesia, as permitted or tolerated. In this review classical technique was used in 100 uncinectomies. Out of this, ethmoidal complex injury was noted in 2 cases,missed maxillary ostium syndrome (incomplete removal) was reported in 8 patients andorbital fat exposure was encountered in 3 patients. As compared to 100 uncinectomies done with swing door technique, incomplete removal was evident in 1 cases and lacrimal duct injury was reported in 1 cases. 'Evidence that underscores how this 'swing door technique' successfully combines 'the conservation goals of the anterior-to-posterior approach and anatomic virtues of the posterior-to-anterior approach to ethmoidectomy of the total 200uncinectomies operated. Out of which 100 uncinectomies have been performed using the'swing-door' technique. The 100 uncinectomies performed using classical technique were usedas controls. The incidence of orbital penetration, incomplete removal, ethmoidal complex injury and ostium non-identification was significantly less with the new technique. One lacrimal injury occurred with the 'swing-door' technique compared to no injuries 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 naturalostium of the maxillary sinus without injuring the ethmoidal complex
Keywords: Classical, Endoscopic surgery, Functional, Sinus, Swing-door technique, Uncinectomy.
