Sublabial Approach Versus Modified Denker’s Procedure: A Comparative Study of Pre-maxillary Tissue Clearance in Covid-Associated Mucormycosis
To compare the efficacy of the sublabial and modified Denker’s procedure in clearance of fungal disease from the anterior wall of maxilla and the pre-maxillary area i.e. the difficult areas of maxillary sinus. A prospective observational study was conducted over a period of 2 months (April 21–June 2...
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Published in | Indian journal of otolaryngology, and head, and neck surgery Vol. 74; no. Suppl 2; pp. 3252 - 3258 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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New Delhi
Springer India
01.10.2022
Springer Nature B.V |
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Abstract | To compare the efficacy of the sublabial and modified Denker’s procedure in clearance of fungal disease from the anterior wall of maxilla and the pre-maxillary area i.e. the difficult areas of maxillary sinus. A prospective observational study was conducted over a period of 2 months (April 21–June 21) in the ENT department of Sawai Man Singh hospital, Jaipur. All the patients with clinical involvement of the premaxilla or the cheek abutting the anterior wall of maxilla were included in the study population. Cases matched in both groups were subjected to debridement either by the sublabial or the modified denker’s approach. Outcomes were measured by assessing the daily CRP values, post-operative DNE every 3 days after pack removal, and imaging at the end of 1 month. Repeat biopsies were performed in patients that still had persistent symptoms after getting operated on. 16 of the 60 patients (26.6%) operated on by the endoscopic approach showed evidence of residual disease on follow-up whereas only 5 patients (9.6%) in the other category had a similar outcome. Most of the recidivism was seen in the anterior maxilla. Lower rates of complications were found following debridement by the sublabial approach. Since the sublabial approach is the most direct approach for the key areas of fungal involvement of maxillary sinus, it is recommended over the modified Denker’s procedure for disease clearance from pre maxilla and the anterior wall of maxillary sinus. This view is also supported by the lower rates of complications encountered following the former. |
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AbstractList | To compare the efficacy of the sublabial and modified Denker’s procedure in clearance of fungal disease from the anterior wall of maxilla and the pre-maxillary area i.e. the difficult areas of maxillary sinus. A prospective observational study was conducted over a period of 2 months (April 21–June 21) in the ENT department of Sawai Man Singh hospital, Jaipur. All the patients with clinical involvement of the premaxilla or the cheek abutting the anterior wall of maxilla were included in the study population. Cases matched in both groups were subjected to debridement either by the sublabial or the modified denker’s approach. Outcomes were measured by assessing the daily CRP values, post-operative DNE every 3 days after pack removal, and imaging at the end of 1 month. Repeat biopsies were performed in patients that still had persistent symptoms after getting operated on. 16 of the 60 patients (26.6%) operated on by the endoscopic approach showed evidence of residual disease on follow-up whereas only 5 patients (9.6%) in the other category had a similar outcome. Most of the recidivism was seen in the anterior maxilla. Lower rates of complications were found following debridement by the sublabial approach. Since the sublabial approach is the most direct approach for the key areas of fungal involvement of maxillary sinus, it is recommended over the modified Denker’s procedure for disease clearance from pre maxilla and the anterior wall of maxillary sinus. This view is also supported by the lower rates of complications encountered following the former. To compare the efficacy of the sublabial and modified Denker’s procedure in clearance of fungal disease from the anterior wall of maxilla and the pre-maxillary area i.e. the difficult areas of maxillary sinus. A prospective observational study was conducted over a period of 2 months (April 21–June 21) in the ENT department of Sawai Man Singh hospital, Jaipur. All the patients with clinical involvement of the premaxilla or the cheek abutting the anterior wall of maxilla were included in the study population. Cases matched in both groups were subjected to debridement either by the sublabial or the modified denker’s approach. Outcomes were measured by assessing the daily CRP values, post-operative DNE every 3 days after pack removal, and imaging at the end of 1 month. Repeat biopsies were performed in patients that still had persistent symptoms after getting operated on. 16 of the 60 patients (26.6%) operated on by the endoscopic approach showed evidence of residual disease on follow-up whereas only 5 patients (9.6%) in the other category had a similar outcome. Most of the recidivism was seen in the anterior maxilla. Lower rates of complications were found following debridement by the sublabial approach. Since the sublabial approach is the most direct approach for the key areas of fungal involvement of maxillary sinus, it is recommended over the modified Denker’s procedure for disease clearance from pre maxilla and the anterior wall of maxillary sinus. This view is also supported by the lower rates of complications encountered following the former. |
Author | Sharma, Anjani Kumar Jat, Kailash Singh Poonia, Ashok Agrawal, Shubham Sharma, Man Prakash Amreen Sharma, Shivam Singhal, Pawan |
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Cites_doi | 10.1002/lary.21863 10.1002/lary.26237 10.1177/194589240501900215 10.2478/rjr-2020-0017 10.1007/s13760-012-0151-9 10.1128/CMR.18.3.556-569.2005 10.1002/ca.22336 10.1007/s00405-005-0919-0 10.3390/jof5010026 10.1017/S0022215106003409 10.2500/ajr.2007.21.3022 10.1017/S0022215121000992 10.1111/j.1445-2197.1995.tb01700.x 10.1097/01.mlg.0000174956.90361.dc 10.1016/B978-0-323-47664-5.00022-5 10.1201/b15118 10.1007/s12070-015-0883-y 10.1016/j.otohns.2004.09.014 10.1001/jama.1908.25410140018002e 10.2500/ajra.2009.23.3333 10.1007/s13410-016-0468-7 10.1007/s12070-018-1530-1 10.1016/j.envres.2021.111643 10.1016/j.ijid.2011.02.005 10.1007/s12070-019-01632-y |
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Keywords | Caldwell-Luc Endoscopic clearance Premaxilla Modified Denker's procedure Infraorbital nerve COVID-associated mucormycosis |
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SubjectTerms | Debridement Fungal infections Head and Neck Surgery Medicine Medicine & Public Health Original Original Article Otorhinolaryngology Sinuses |
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Title | Sublabial Approach Versus Modified Denker’s Procedure: A Comparative Study of Pre-maxillary Tissue Clearance in Covid-Associated Mucormycosis |
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