Hamartoma — what it is, the progress of the operation and consequences of
What is hamartoma
After the usual colds and viral diseases of nasopharynx, often there are complications that require more serious treatment is surgery. When conservative methods in the form of nasal lavage, medicines, use of vasoconstrictor, and the oil drops are not effective, and the patient’s condition is deteriorating is hamartoma. It is a surgical procedure designed to eliminate pathological mucus from the maxillary sinuses.
The intervention is run as a standard way – a radical hamartoma (reviews can be read below), and using minimally invasive techniques, endoscopic technique.
Indications and contraindications for prompt action
The opening of the maxillary sinuses is performed in specific circumstances:
- the lack of results from the conservative approach;
- the presence in the nasal cavity, polyps, cysts;
- type of odontogenic sinusitis;
- benign tumors;
- blood clots;
- the chronic form of the disease;
- the foreign objects.
Sometimes the reason for the surgery on the maxillary sinuses getting bad dental work, the outcome of which is damage to the lower wall of the nasal sinuses.
To prohibitions on the conduct of hamartoma include:
- high risk of deterioration of the patient;
- the exacerbation of infectious and chronic diseases of the General plan;
- of blood clotting;
- the presence of inflammatory process in the access point to the sinuses.
In a number of preparatory events before the opening of the maxillary sinus consists of laboratory and instrumental methods of examination.
- General analysis of blood;
- an x-ray or CT scan.
Also need a waiver of the meal for 6-7 hours before the operation.
The types of hamartoma
Distinguish between radical and sparing approach. Standard methods are available for Moore, Denker, Simanto.
But the most common operation hamartoma for Caldwell-Luc. Is performed under the influence of General or local anesthesia in the following way:
- First made deep to the bone, the incision of 2-3 cm in on the gums under the upper lip.
- The soft tissues are moved aside, exposing the bone.
- With the help of medical bits (sometimes borax) in the front wall of the maxillary sinus is done a hole with a diameter, sufficient to free the tools.
- Pathological the contents carefully removed (vystavlyaetsya) mucous membranes with a special spoon, the cavity saniyede.
- Unaffected portion of the mucous membrane in the form of a flap placed on the bottom of the maxillary sinus for the speedy recovery of the integral cover.
- In the nasal cavity are introduced styptic swabs, hindering the accumulation of pus, and the incision sutured.
The effects of the radical approach
During a radical intervention it is also possible to reposition the zygomatic bone and the sampling of biological material for further studies. Especially the biopsy is important in suspected malignant formations in the nasal cavity.
Important! Swelling after hamartoma – the phenomenon frequent enough. For its reduction it is recommended the application of a pressure bandage or ice on his cheeks and lifting the head end of the bed.
Tampons are eliminated in two days after surgery, and sutures are removed at 5-7 days.
In addition to edema, which provokes a radical hamartoma, the consequences can be in the form of numbness of the dentition and cheeks from the operation, reduce sensitivity of the nose and smell, sometimes – aching pain and heaviness in the maxillary sinuses.
It is also possible to more serious complications such as:
- excessive bleeding;
- the formation of the fistula;
- damage to the trigeminal nerve.
However, the risk of such situations is low enough to hamartoma remains the most effective method of treatment of inflammation in the maxillary sinuses and prevent the life-threatening conditions – meningitis, encephalitis, sepsis.
What is endoscopic hamartoma?
Gentle method implemented in endoscopic hamartoma is the elimination of mucus from the maxillary sinuses, which is not accompanied by the breakdown of soft tissues and formation of scars. Is carried out using a special medical camera – endoscope, which performs a diagnostic function. Monitoring of each manipulation is carried out through a microscopic camera that displays the image on the computer monitor.
Because of this the surgeon promptly evaluates each moment of operation, and the doctors clearly verified and accurate.
With the help of an endoscope to the maxillary sinus can be reached in five ways:
- through the middle traverse of the nose;
- through the lower course;
- through a small depression, referred to as the «canine fossa», located on the upper jaw;
- through the dental alveolus;
- through the maxillary tuberosity.
Based on the characteristics of the anatomical structure, of the disease and presence of contraindications in the case of each particular patient is selected your most convenient and efficient method of access.
At the present moment is increasingly used endoscopic hamartoma; the progress of the operation (video, see), which is a puncture, enlargement of physiological holes, and suctioning of mucus, allows us to reduce tissue trauma to a minimum. Diameter of punctures does not exceed 4 mm.
Besides, this technique causes less postoperative pain than radical approach, and the rehabilitation time is reduced by almost half. The advantages of this type of intervention include the possibility of holding an outpatient basis, as time manipulation is no more than 30 minutes, and significantly reduced blood loss.
Through the gentle technique, which applies endoscopic hamartoma, postoperative period runs a lot faster and less painfully. Due to the fact that with such a technique effects on the maxillary sinus of healthy tissue is retained, restoration of the mucous membranes takes less time. Exterior no visible defects remains, and subsequent lesions of the nasal cavity the air passage is not closed, in the future will facilitate treatment.
Using the tools with the endoscope not only eliminate inflammation in the maxillary and other sinuses, but recovered trapped in the cavity foreign objects.
Therapy after surgery
Immediately after conducted standard hamartoma the patient needed rest and careful observance of personal hygiene of the oral cavity, since it is closely related to sinus may pick up the infection and lead to re-abscess. To reduce pain use painkillers, if necessary, apply sedatives.
A few days after the intervention of the sinus washed with saline.
Treatment after endoscopic hamartoma involves taking antibacterial medications, adherence to all medical instructions and careful hygiene.
It’s also essential the patient after surgery has been observed for some time (usually 2-3 days) otolaryngologist.
Among other things, the rehabilitation after hamartoma is to avoid crowded places, not to trigger a new infection, the consumption of adequate amounts of fluid, maintaining the highest possible a healthy lifestyle.
Hope for self healing and postponing a visit to the doctor during normal rhinitis fraught with transformation of the «classic» runny nose to sinusitis, which in turn, can develop into a chronic form and become a serious danger to the overall health.