Nose Treatment


It is a procedure done both for diagnosis and treatment of sinusitis, where a canula is inserted into the maxillary sinus via an opening made in the inferior meatus. It was widely practiced before FESS surgery.


    Antral Lavage:

  • (a) It is done in cases of chronic maxillary sinusitis, not responding to conservative medication.
  • (b) This procedure can also be done for instillation of medication and irrigation in cases of atrophic rhinitis.

  • 1. Proof puncture: Radiological appearances of sinusitis is confirmed by a puncture.
  • 2. The washing can be sent for pus, smear culture, antibiotic sensitivity and cytological examination.

  • Not done in children below 3 years of age due to proximity of the orbital floor and teeth in small maxillary sinus.
  • Traumatic conditions damaging orbital floor and maxilla.

    The 3 main nerves blocked by local anesthesia are:

  • (a) Superior alveolar nerve near the inferior meatus.
  • (b) Anterior ethmoidal nerve near the roof of the nose.
  • (c) Posteriorly the sphenopalatine ganglion.
Puncture sides:

The Tilley- Lichtwitz trocar and cannula is passed under the attachment of the inferior turbinate up-to the genu pointing to the homolateral ear.

  • A Higginson’s syringe with sterile or normal water at 37 Degree Celsius is attached to cannula and the maxillary sinus is flushed.
  • Three successive flushed of clear saline water are required. Dilute potassium permanganate or povidone iodine washes can also be given.
  • Bleeding: This occur from local blood vessels.
  • Orbital damage: Perforation of the orbital floor causing proptosis and pain.
  • Cheek swelling: Breaching of soft tissue of the cheek and anterior wall.
  • Air embolism due to injury to veins.
  • Infection of maxillary sinus.
  • Vasovagal Shock.
  • Anesthesia complications.

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