Utility of Current Sialendoscopes in the Sinonasal Cavity

Abstract

Objective: 1) To describe the utility of current sialendoscopes in the paranasal sinuses in a cadaveric model. 2) To suggest the novel uses for sialendoscopes and potential improvements in design.

Method: A cadaveric study was performed in a tertiary care hospital setting in October 2011. Currently available sialendoscopes were used for visualization and interventions in the paranasal sinuses. Four cadaver heads were studied pre- and postdissection. Outcomes included identification of ostia, cannulation of sinuses, success of mucosal biopsy, and clarity of images.

Results: There were no significant differences in types of scopes. Both Marchal and Erlangen scopes were demonstrated to be effective in both visualizing and cannulating the sphenoid sinuses in pre- and postdissected settings (8/8). Neither type allowed for adequate visualization of the maxillary ostia without dissection, but did allow for evaluation and cannulation after antrostomy. Larger diameter scopes were associated with the least distortion of image during assessment of the maxillary ostia. Mucosal biopsy within the sphenoid sinus was possible before dissection, but not in the maxillary sinus.

Conclusion: Sialendoscopes can be used for visualization and interventions in the sinonasal cavity but are limited mainly to the sphenoid sinus. They may be considered as a minimally-invasive method for drug delivery and/or biopsy in the postoperative setting for all sinuses. The design can be improved somewhat.