Sinuscopy is a reflection of the maxillary sinus, which is performed with the help of an endoscope. This allows diseases of the maxillary sinus to be diagnosed and treated.
What is sinuscopy?
Sinuscopy is a reflection of the maxillary sinus performed with the help of an endoscope. This allows diseases of the maxillary sinus to be diagnosed and treated. The maxillary sinus (Latin: sinus maxillaris) is one of the paranasal sinuses and is roughly shaped like a three-sided pyramid. The maxillary sinus consists of air-filled cavities in the bone (pneumatization spaces), which are lined with a mucous membrane about 1 mm thick. The mucosa ensures the self-cleaning of the maxillary sinus by removing fluids and mucus from the maxillary sinus. The volume of the maxillary sinuses is about 12 to 15 ml when their growth is complete. They are located to the right and left of the nose and are adjacent to the orbits and, in the lower region, to the maxillary teeth. The maxillary sinus is connected to the nasal cavity by a small opening and is ventilated through this. However, this also means that infectious agents can enter the maxillary sinus through this connection. The tasks that the maxillary sinus performs in our body are still unclear – experts assume that, among other things, they are involved in the sense of smell, moisten and warm the inhaled air, and serve as a resonance amplifier for the voice. An examination of the maxillary sinus is performed when there is a suspicion of disease, especially tumors. With the help of sinuscopy, a diagnosis can be made and, depending on the findings, minor procedures can be performed. Sinuscopy is performed with the help of endoscopes through the nose, but in some cases through the oral cavity.
Function, effect, and goals
Sinuscopy is used when a patient is suspected of having sinus disease. Often, the patient is symptom-free. However, symptoms may include headache, facial pain, swollen mucosa, or secretion in the nasopharynx. The secretion flow can cause coughing or bronchitis, among other symptoms. Furthermore, nasal breathing and the ability to smell can be impaired in maxillary sinus disease. In order to make a reliable diagnosis, a nasal endoscopy, known as rhinoscopy, is often performed after interviewing the patient. Imaging techniques such as ultrasound, computer tomography, magnetic resonance imaging (MRI) and blood tests are also used to establish the diagnosis. Allergy diagnostics are also performed. Sinuscopy is then used to differentiate between benign and malignant findings and inflammations. Sinuscopy is performed either under general or local anesthesia. Prior to the procedure, blood clotting medication should be discontinued in consultation with the physician, if necessary. Depending on the type of anesthesia, nothing should be eaten or drunk for some time before the procedure. Smoking is also prohibited. In order to be able to examine the mucous membrane in the maxillary sinus from different angles, an optical device, an endoscope, is inserted. This is usually done through the nasal passage and connection into the maxillary sinus. However, sometimes the endoscope is inserted through a small drilled bone window in the upper jaw. If there are suspicious findings when looking at the mucosa, a sample can be taken with the help of the endoscope. Existing small growths or mucosal changes such as cysts or polyps can already be removed by the doctor at this stage. Small foreign bodies can also be removed from the maxillary sinus endoscopically. After the endoscopy, tamponades are inserted into the nose to absorb blood and wound secretions. After a few days, this tamponade can be removed again. However, the nose should not be blown for the time being. Instead, when secretions are drained, blotting is advisable. In some cases, it is advisable to go to the doctor so that he or she can aspirate the secretion. Replenishing nasal ointments also provide further care for the sore area. Patients should avoid heat and cool the cheek to aid in faster healing and swelling. If sinuscopy is performed via the oral vestibule, patients should not eat solid foods for the first few days. If brushing the teeth is not possible, the mouth can be rinsed regularly with a disinfecting solution on the advice of the treating physician.Because of the effects of medication, patients should arrange to be picked up or take a cab after sinuscopy – they are considered unfit to drive for at least 24 hours following the procedure.
Risks, side effects, and hazards
Following the performance of the procedure, there may be damage to organs located near the maxillary sinus. Bleeding, secondary bleeding, inflammation, wound healing problems or bruising may also occur. In rare cases, the reflection leads to feelings of numbness or paralysis, which have their cause in nerve injuries in the surgical area. In particular, the infraorbital nerve (nervus infraorbitalis), which is the direct continuation of the maxillary nerve (nervus maxillaries), passes through this area in a bony demarcated canal. These complications may be temporary, but in some cases they may be permanent. They also entail an impairment of the sense of smell. Smelling can also be negatively affected by scarring. Scarring can also lead to respiratory problems. Very rarely, drying of the nasal mucosa occurs in combination with a very unpleasant odor, the so-called stinky nose. The latter can occur when the mucosa is severely damaged. It begins to decompose, the tissue dies and germs can settle unhindered. Visual problems, even blindness, have been recorded as a result of sinuscopy in only a few cases. However, allergic reactions can occur in various degrees.
