Endoscopic Approach to Organized Hematoma of Maxillary Sinus Using the Swinging Technique of Nasolacrimal Duct and Inferior Turbinate

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  • Kitamura Yoshiaki
    Department of Otolaryngology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Miyoshi Hitomi
    Department of Otolaryngology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Matsuoka Momoyo
    Department of Otolaryngology, Yashima General Hospital
  • Fujii Tatsuya
    Department of Otolaryngology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Matsuda Kazunori
    Department of Otolaryngology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Takeda Noriaki
    Department of Otolaryngology, Institute of Health Biosciences, The University of Tokushima Graduate School

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  • 鼻涙管下鼻甲介スイング法にて内視鏡下に摘出した上顎洞血瘤腫例

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We report a 63-year-old woman with recurrent nasal bleeding diagnosed with organized hematoma in the maxillary sinus. Computed tomography showed an expanding lesion with thinning and defect of the adjacent bone and magnetic resonance imaging showed heterogeneous signal intensity with thickening of the maxillary sinus mucosa and marked patchy enhancement. After selective embolization of the feeding artery, we conducted endoscopic sinus surgery and applied the swinging technique of the nasolacrimal duct and inferior turbinate for resection of the organized hematoma. It provides a wide surgical field for the maxillary sinus, resulting in en bloc resection with a straight endoscope and instruments. The postoperative course was uneventful and no recurrence was observed in the 1.5-year follow-up. The swinging technique allows wide and direct access to the maxillary sinus through anterior space of the nasolacrimal duct without damaging the nasolacrimal duct or inferior turbinate mucosal function. This technique is a safe and effective method to remove benign maxillary sinus diseases endoscopically by good accessibility to and visualization of the maxillary sinus.

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