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A Journal on Dentistry and Maxillofacial Surgery
Minerva Stomatologica 2002 November-December;51(11-12):515-22
Rhino-sinusal endoscopy as a diagnostic and therapeutic treatment in patients undergoing a bone marrow transplantation
Belli E., Matteini C., Marini Balestra F.
Immunodepressed subjects appear to present as a common adverse event the infections complication of paranasal sinuses which can lead to an unfavourable clinical evolution spreading the infection to encephalic and endo-orbital tissues. The patients described by the authors present a common clinical history of neoplastic disorders concerning the haemopoietic tissue with an indication for bone marrow transplantation. These patients also demonstrated clinical-radiological evidence of rhino-sinusal impairment with specific maxillary sinus involvement. The clinical condition obliged us to reach a final diagnosis of the origin of rhino-sinusal involvement which clearly appeared by performing imaging diagnostic examinations in order to rapidly establish the correct therapy. The resolution of the rhino-sinus complication allows these patients to follow on the treatment for their own initial pathology. In fact, in order to resume the treatment against haemoblastic disorders, an essential step is to approach the paranasal sinus affection. Endoscopy, in the cases reported, permitted us to obtain a correct diagnosis and to develop a correct antimicrobic therapy, achieving the drainage of the maxillary sinus as well. Endoscopy achieved the same results as radical surgery of the maxillary sinus by the Caldwell-Luc approach, proving less aggressive and reducing operative timing, postoperative recovery timing and intra and post operative haemorrhagic complications. Moreover, endoscopy characteristics present a specific validity in patients with severe general conditions, which are described in the examined group, reducing time for diagnosis and therapy resulting specific to solve the rhino-sinus complication and also particularly important in order to interfere less with the delicate medical therapy for the primary pathology by the sample examined.