Feasibility of Minimal Inferior Meatal Antrostomy and Fiber-Optic Sinus Exam for Fungal Sinusitis

Background/objective The aim of this study was to evaluate the usefulness of simultaneous middle and inferior meatal antrostomies (SMIAs) as a treatment modality in patients with maxillary fungal sinusitis and to compare the efficacy of SMIA with that of conventional middle meatal antrostomy (MMA). Methods A retrospective study was performed on consecutive patients with noninvasive fungal maxillary sinusitis. Twenty-one patients underwent endoscopic sinus surgery with SMIA group and the remaining 24 patients were treated with the conventional MMA group. Medical records were reviewed for history, clinical presentation, radiographic findings, surgical intervention, complications, and outcomes. Outcomes consisted of the visual analog scale (VAS) for the main symptoms and maxillary sinus endoscopic scores. The stenosis or obstruction of the antrostomy site and postoperative mucociliary function was also evaluated. Results VAS scores for facial pain and nasal discharge/postnasal drip were significantly improved in the SMIA group. The maxillary endoscopic score was also significantly reduced in the SMIA group. There were no significant differences between 2 groups with respect to the preoperative Lund–Mackay score, VAS score of nasal obstruction, nasal bleeding, postoperative mucociliary function, and MMA patency. Conclusions The SMIA technique is useful for identifying and removing fungal debris that cannot be reached through the MMA and could bring better surgical outcomes.