Introduction The endoscopic access has reduced the morbidity associated with external approaches in diseases of the maxillary sinus. A reversible endoscopic medial maxillectomy (REMM) is presented as an alternative for treatment of benign maxillary diseases. Objective To describe the REMM technique and report four cases of patients with benign maxillary sinus conditions treated through this approach. Methods The present study was divided into two parts: anatomical and case series. Two cadaveric dissections confirmed the feasibility of the REMM approach. The same technique was performed on four consecutive patients with benign maxillary sinus disease. Results The cadaveric dissections confirmed wide exposure to the maxillary cavity, preserving the anatomy of the maxillary sinus. In the patient series, one patient presented with an antrochoanal polyp, one had a silent sinus syndrome, one had a chronic maxillary sinusitis secondary to a gunshot, and the last one had an inverted papilloma in the maxillary sinus. In all of the cases, the REMM approach provided excellent access and adequate resection, as well as preservation of the inferior turbinate, nasolacrimal duct, and lateral wall of the nose (including its osteomucosal component). Finally, all of the patients had an uneventful postoperative course. Conclusion The REMM technique is an excellent surgical approach to benign conditions of the maxillary sinus. It has few limitations and appears to be associated with less morbidity than conventional techniques.

The literature is scarce on pathological studies of the vagus nerve in patients known to have chronic autonomic diabetic neuropathy. Most of the morphological studies of the vagus nerve in experimental diabetes involve the study of the abdominal segment of this nerve or its mesenteric branches. In these studies, the authors demonstrate a presence of diabetic neuropathy and characterize the dying back process of this neuropathy. However, the morphological lesions described by these authors are exclusive of the unmyelinated fibers, since in these segments, the vagus nerve no longer presents myelinated fibers. The objective of the present study was to investigate the existence of morphological and morphometric alterations of the cervical vagus nerve myelinated fibers in acute and chronic experimental diabetes. Male Wistar rats received a single injection of streptozotocin (40mg/kg) 15 days (n = 6) or 12 weeks (n = 6) prior to the experiments. Control rats (n = 6) received equal volume of citrate buffer solution. Proximal and distal segments of the cervical vagus nerves had their fascicle and myelinated fibers and respective axons measured with the aid of computer software. The morphometric data comparison was performed between segments in the same nerve, sides and groups and differences were considered significant when p <0.05. Our results show that there are alterations in the morphology and morphometry of myelinated fibers and axons of the vagus nerve in diabetic animals, especially in their distal segments in both experimental groups. However, in the chronic diabetic group the alterations were more evident and committed the proximal segments. Thus, the results suggest a presence of axonal neuropathy in the vagus nerve due to experimental diabetes, and that alterations were progressive in a time dependent manner.Support or Funding InformationFAEPA, CAPES and CNPqThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.