Maxillary antral lavage--infiltration and surface anaesthesia compared

Hemostasis during functional endoscopic sinus surgery: the effect of local infiltration with adrenaline

OBJECTIVES

To determine the feasibility of the use of a topical vasoconstrictor for hemostasis during functional endoscopic sinus surgery.

STUDY DESIGN

Case-control study.

SUBJECTS AND METHODS

From May 1998 to August 2002, 226 patients (injection group) with bilateral chronic rhinosinusitis received an adrenaline injection for hemostasis during functional endoscopic sinus surgery at our tertiary referral center. After September 2002, topical adrenaline was applied for hemostasis in 226 consecutive patients (noninjection group) who underwent the same surgery. The two groups were matched by age, sex, body weight, stage of chronic rhinosinusitis, and pre-anesthesia blood pressure. The hemostatic effects in each group were analyzed.

RESULTS

No statistically significant differences in operation time and intraoperative blood loss were reached between the two groups of patients.

CONCLUSIONS

Topical use of adrenaline achieved similar hemostatic effect compared with injection of adrenaline. Intranasal injection of a vasoconstrictor, in consideration of its adverse effects, may be avoided during surgery.

Maxillary antral lavage using inferior meatal cannula anaesthesia

Antral puncture and lavage through the inferior meatus is a minor but common otolaryngological procedure, usually performed under local anaesthesia. We describe a new method of introducing local anaesthetic into the inferior meatus, via the use of a soft intravenous cannula connected to a syringe containing 10 per cent cocaine paste. We have called this new technique inferior meatal cannula anaesthesia (IMCA).