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How I do it:- Endoscopic Reverse Denker’s Approach

Introduction: Endoscopic Denker’s approach involves complete exposure of the anterior, inferior and lateral walls of the maxillary sinus providing access to both infratemporal and pterygopalatine fossa. Open approaches to maxillary sinus may lead to a high chance of cranial nerve dysfunction, trismu...

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Autores principales: Ahilasamy, Nagalingeswaran, Narendrakumar, Veerasigamani, Kumar, Rajendran Dinesh, Baby, Arya N, Kumar N, Manoj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer India 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9761640/
https://www.ncbi.nlm.nih.gov/pubmed/36571093
http://dx.doi.org/10.1007/s12070-022-03330-8
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author Ahilasamy, Nagalingeswaran
Narendrakumar, Veerasigamani
Kumar, Rajendran Dinesh
Baby, Arya N
Kumar N, Manoj
author_facet Ahilasamy, Nagalingeswaran
Narendrakumar, Veerasigamani
Kumar, Rajendran Dinesh
Baby, Arya N
Kumar N, Manoj
author_sort Ahilasamy, Nagalingeswaran
collection PubMed
description Introduction: Endoscopic Denker’s approach involves complete exposure of the anterior, inferior and lateral walls of the maxillary sinus providing access to both infratemporal and pterygopalatine fossa. Open approaches to maxillary sinus may lead to a high chance of cranial nerve dysfunction, trismus and wound healing issues. Surgical methods differ based on pathology, exposure, visualization and extent of clearance of the pathology. Method: The technique and surgical steps of Endoscopic Reverse Denker’s approach are presented. Results: Critical steps include inferior turbinectomy, uncinectomy, followed by mega middle meatal antrostomy. For exposure drilling is started from the anterior margin of middle meatal antrostomy up to the pyriform aperture anteriorly till the anterior wall of the maxilla is visualized and the nasolacrimal duct can be visualized and transected. This method preserves the pyriform aperture and anterior wall similar to inside-out mastoidectomy tracing the pathology with less bone removal, faster and less morbidity. Conclusion: Endoscopic Reverse Denker’s is a 2-handed or 4-handed endoscopic technique for proper exposure, visualization and clearance of the maxillary pathology of the anterolateral and anterior wall. Olfaction is preserved and crusting is less as there is less bone removal with no atrophic nasal changes. It preserves the pyriform aperture thereby preventing alar collapse.
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spelling pubmed-97616402022-12-19 How I do it:- Endoscopic Reverse Denker’s Approach Ahilasamy, Nagalingeswaran Narendrakumar, Veerasigamani Kumar, Rajendran Dinesh Baby, Arya N Kumar N, Manoj Indian J Otolaryngol Head Neck Surg Brief Communication Introduction: Endoscopic Denker’s approach involves complete exposure of the anterior, inferior and lateral walls of the maxillary sinus providing access to both infratemporal and pterygopalatine fossa. Open approaches to maxillary sinus may lead to a high chance of cranial nerve dysfunction, trismus and wound healing issues. Surgical methods differ based on pathology, exposure, visualization and extent of clearance of the pathology. Method: The technique and surgical steps of Endoscopic Reverse Denker’s approach are presented. Results: Critical steps include inferior turbinectomy, uncinectomy, followed by mega middle meatal antrostomy. For exposure drilling is started from the anterior margin of middle meatal antrostomy up to the pyriform aperture anteriorly till the anterior wall of the maxilla is visualized and the nasolacrimal duct can be visualized and transected. This method preserves the pyriform aperture and anterior wall similar to inside-out mastoidectomy tracing the pathology with less bone removal, faster and less morbidity. Conclusion: Endoscopic Reverse Denker’s is a 2-handed or 4-handed endoscopic technique for proper exposure, visualization and clearance of the maxillary pathology of the anterolateral and anterior wall. Olfaction is preserved and crusting is less as there is less bone removal with no atrophic nasal changes. It preserves the pyriform aperture thereby preventing alar collapse. Springer India 2022-12-19 2023-04 /pmc/articles/PMC9761640/ /pubmed/36571093 http://dx.doi.org/10.1007/s12070-022-03330-8 Text en © Association of Otolaryngologists of India 2022
spellingShingle Brief Communication
Ahilasamy, Nagalingeswaran
Narendrakumar, Veerasigamani
Kumar, Rajendran Dinesh
Baby, Arya N
Kumar N, Manoj
How I do it:- Endoscopic Reverse Denker’s Approach
title How I do it:- Endoscopic Reverse Denker’s Approach
title_full How I do it:- Endoscopic Reverse Denker’s Approach
title_fullStr How I do it:- Endoscopic Reverse Denker’s Approach
title_full_unstemmed How I do it:- Endoscopic Reverse Denker’s Approach
title_short How I do it:- Endoscopic Reverse Denker’s Approach
title_sort how i do it:- endoscopic reverse denker’s approach
topic Brief Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9761640/
https://www.ncbi.nlm.nih.gov/pubmed/36571093
http://dx.doi.org/10.1007/s12070-022-03330-8
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