Place of Middle Meatotomy in the Management of Rhinologic Chronic Sinusitis

Introduction: Middle meatotomy is an effective surgical technique in the management of chronic sinusitis rebels to medical treatment. It is an optimal therapeutic option in the face of a chronic sinusitis particularly of rhinological origin. Patients and method: It is a descriptive retrospective study over an 11-year period from January 2009 to December 2019 at the service of Otolaryngology and Cervico-facial surgery (ORL-CCF) at the Andohatapenaka University Hospital Antananarivo Madagascar. Our study includes subjects who have benefited from an average meatotomy on chronic sinusitis. Results: We collected 320 patients of average age of 33.78 years. Repetitive maxillary sinusitis and rhinogenic allergies are the determinants of chronic sinusitis. Nasal obstruction was the constant functional sign and anterior rhinoscopy revealed a red nasal mucosa with enlarged inferior turbinate. All of our patients received an incidence X-ray of Blondeau. The average meatotomy was achieved in all our patients and among them, a proportion of 12.50% of the cases operated at the same time of a medium meatotomy and opening of other meatus. Complementary turbinal surgery was used in 25% of cases. Therapeutic efficacy was assessed subjectively by the subject’s functional signs. Favourable trends were reported in 75.30% of cases. Conclusion: Chronic sinusitis is a naso-sinus condition requiring medical-surgical management. The middle meatotomy is the first step in the surgical management of chronic rhinological sinusitis rebellious to medical means.