Schneiderian Membrane Regeneration After Lateral Bony Window Repositioning in Modified Endoscopic-Assisted Maxillary Sinus Surgery: Transmission Electron Microscopy Evaluation. Issue 7 (3rd October 2022)

• Record Type: Journal Article
• Authors: Han, Jeong Joon; Sodnom-Ish, Buyanbileg; Eo, Mi Young; Kim, Yoon Joo; Oh, Ji Hye; Yang, Hoon Joo; Kim, Soung Min
• Is Part Of: Journal of craniofacial surgery. Volume 33:Issue 7(2022)
• Page Start: e701
• Page End: e706
• Publication Date: 2022-10-03
• Subjects: Histopathology -- modified endoscopic sinus surgery -- odontogenic maxillary sinusitis -- regeneration -- Schneiderian membrane -- ultrastructure; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000008603
• Languages: English
• ISSNs: 1049-2275

Abstract

Abstract : Purpose: Regeneration of Schneiderian membrane (SM) and restoration of physiologic function of a maxillary sinus are essential for successful treatment of odontogenic maxillary sinusitis (OMS). In the present study, the surgical procedures of modified endoscopic sinus surgery (MESS) for treatment of OMS were described with special focus on regeneration of SM and favorable bone healing in the lateral bony window repositioning procedure. Methods: The regeneration of the SM after MESS was assessed based on clinical, histological, and ultrastructural findings. The study included 66 patients who received MESS with repositioning of the lateral bony window for treatment of OMS. Results: In the inflamed maxillary sinus membrane, squamous metaplasia was observed with infiltration of inflammatory cells including neutrophils, eosinophils, and plasma cells. Although partial loss of the cilia was observed in the epithelium, the majority of epithelial cells was ciliated. Clinically acceptable partial or complete bone healing was observed without occurrence of postoperative maxillary cyst or invasion of soft tissue into the sinus cavity for all patients at an average of 1.4 ± 1.2 years after MESS. On histopathological and ultrastructural examinations of the healed soft tissue, significant inflammatory features were not found, and fibroblasts with abundant collagen fibers were the main findings. Conclusions: These results indicate that repositioning of the lateral bony window leads to regeneration of the SM and favorable bone regeneration without occurrence of complications associated with transmaxillary approaches and can contribute to maintaining normal physiological function of the maxillary sinus.