Safety of sphenoid aspiration for diagnosis and treatment of intensive care unit rhinosinusitis

Safety of sphenoid aspiration for diagnosis and treatment of intensive care unit rhinosinusitis

Author Jardim Vieira, Fernando Mirage Autor UNIFESP Google Scholar
Silva, Rogerio Nunes da Autor UNIFESP Google Scholar
Stefanini, Renato Autor UNIFESP Google Scholar
Balsalobre Filho, Leonardo Lopes Autor UNIFESP Google Scholar
Santos, Rodrigo de Paula Autor UNIFESP Google Scholar
Stamm, Aldo Autor UNIFESP Google Scholar
Gregório, Luiz Carlos Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background: in intensive care units (ICUs), critically ill patients may be exposed to several risk factors for developing acute rhinosinusitis, including nasogastric tubes, mechanical ventilation, and prolonged periods in the supine position. the incidence of acute rhinosinusitis can be as high as 83%, the third or fourth most frequent ICU infection and it increases the risk of developing ventilator-associated pneumonia. Diagnosis and therapeutic approaches should be more aggressive than in non-ICU patients. Antral puncture plays a central role in the diagnosis and treatment of these patients. This study was designed to show the development of a method for sphenoid puncture in the diagnosis and treatment of acute infectious rhinosinusitis in critically ill patients, analyzing safety and complications.Methods: Patients in ICUs with endoscopic and radiological diagnosis of acute rhinosinusitis were included. Maxillary puncture was performed through the inferior meatus; sphenoid puncture was performed by endoscopic identification of the sphenoethmoidal recess. An aspiration probe was introduced into the natural sphenoidal ostium, followed by aspiration of secretions and saline irrigation.Results: Twenty-nine patients were included. Twenty-seven patients (93.1%) presented with sphenoidal sinusitis, 24 patients (82.7%) had maxillary sinusitis, 21 patients (72.4%) had ethmoidal sinusitis, and 13 patients (44.8%) had frontal sinusitis. Forty-seven sphenoidal and 39 maxillary punctures were performed. No major bleeding or other complications were recorded.Conclusion: the sphenoid puncture is a possible procedure to be performed in an ICU and might complement the paranasal puncture in cases of acute rhinosinusitis. (Am J Rhinol Allergy 24, 389-391, 2010; doi: 10.2500/ajra.2010.24.3512)
Language English
Sponsor Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Date 2010-09-01
Published in American Journal of Rhinology & Allergy. Providence: Ocean Side Publications Inc, v. 24, n. 5, p. 389-391, 2010.
ISSN 1945-8924 (Sherpa/Romeo, impact factor)
Publisher Ocean Side Publications Inc
Extent 389-391
Origin http://dx.doi.org/10.2500/ajra.2010.24.3512
Access rights Closed access
Type Article
Web of Science ID WOS:000283002800014
URI http://repositorio.unifesp.br/handle/11600/32903

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