Author/Editor		Spudič, Štefan; Podboj, Jernej
Title		Tujki v obnosnih votlinah
Translated title		Foreign bodies in paranasal sinuses
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 39, št. Suppl 3
Publication year		2000
Volume		str. 281-4
Language		slo
Abstract		Foreign bodies in paranasal sinuses are of iatrogenic or traumatic origin and are seen mainly in adults. During the period between 1995 and 1999, thirteen patients aged 25 to 64 were treated for complications of foreign bodies in paranasal sinuses at the Otorhinolaryngology and Cervicofacial Surgery Department, University Medical Centre Ljubljana and at the ENT Department of the Novo Mesto General Hospital. Foreign bodies were found in ten patients who had received endodontic treatment and only three cases were of traumatic origin. Most traumatic foreign bodies were discovered and removed a few days after the trauma, while foreign bodies of iatrogenic origin took several years to be diagnosed. Foreign bodies were removed endoscopically in ten cases. The classical sublabial approach was used in only three cases. There were no intraoperative or postoperative complications and postoperative endoscopy confirmed the success of therapy. A detailed medical history, ENT examination including endoscopy of the nose, standard radiography or, even better, a CT scan and in some cases MRI are required. Only an otorhinolaryngologist in cooperation with a dentist can prevent complications by immediate diagnosis and extraction of foreign bodies of iatrogenic origin. On the other hand, one must always be aware of the possibility of the presence of a traumatic foreign body in patients with trauma to the head or the eyes. First an attempt should be made to remove a foreign body endoscopically; the classical external approach is used only if the foreign body is inaccessible to endoscopic instruments or in cases when the foreign body is too big to be extracted through the nostrils.
Summary		Tujke v obnosnih votlinah najdemo predvsem pri odraslih. Največkrat so iatrogeni ali pa posledica poškodb. Od leta 1995 do 1999 smo na otorinolaringološkem oddelku Splošne bolnišnice Novo mesto in na Kliniki za otorinolaringologijo in cervikofacialno kirurgijo v Ljubljani obravnavali 13 bolnikov s tujki v obnosnih votlinah, starih od 25 do 64 let. Pri 10 bolnikih so bili tujki iatrogeni, pri 3 bolnikih pa posledica poškodb. Tujki, ki so bili nasledek poškodb, so bili večinoma odkriti v nekaj dneh, medtem ko je preteklo do odkritja iatrogenih tujkov več mesecev ali celo let. Pri 10 bolnikih smo tujek odstranili s pomočjo endoskopske tehnike, pri treh pa smo uporabili klasičen sublabialni pristop. Zapletov med operacijami in po njih ni bilo, kontrolni endoskopski pregledi pa so potrdili uspeh zdravljenja. Glede na pestro klinično sliko pri tujkih obnosnih votlin je za prepoznavo in lokalizacijo potrebna natančna anamneza, otorinolaringološki pregled z endoskopijo nosu, rentgenska slika obnosnih votlin v dveh projekcijah, še bolje računalniška tomografija, včasih tudi magnetna resonanca obnosnih votlin. Sodelovanje med stomatologom in otorinolaringologom omogoči takojšnje odkritje in odstranitev iatrogenih tujkov, še preden nastanejo zapleti. Pri penetrantnih poškodbah obraza in očnice moramo vselej pomisliti na možnost tujka v obnosnih votlinah. Tujke poskušamo najprej odstraniti endoskopsko, klasičen pristop uporabimo le v primerih, ko je tujek prevelik ali pa nedostopen endoskopskim instrumentom.
Descriptors		PARANASAL SINUSES FOREIGN BODIES TREATMENT OUTCOME SURGERY, ENDOSCOPIC POSTOPERATIVE COMPLICATIONS MULTIPLE TRAUMA