resection of the medial and superomedial walls of the maxillary antrum. It is increasingly being done by transnasal endoscopic technique for suitable cases. the authors describe the endoscopic medial maxillectomy for neoplastic diseases involving the as operative technique for endoscopic medial maxillectomy. Conclusion Modified endoscopic medial maxillectomy appears to be an effective surgery for treatment of chronic, recalcitrant maxillary sinusitis.

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In this approach, the maxillary sinus is operated upon, while the inferior turbinate and nasolacrimal duct are preserved. As previously described by the senior author N. Values measured included the volume of the maxillary sinus inferior to a transverse line through the most superior insertion of the inferior turbinate to the lateral nasal wall hereinafter, V1the volume of the maxillary sinus superior to this line hereinafter, V2the volume of the maxillary sinus anterior to the most posterior portion of the nasolacrimal canal hereinafter, V3and the total volume of the maxillary sinus hereinafter, V4.

However, EMM usually removes the inferior turbinate and nasolacrimal duct.

The mean SD V5 was Results of endoscopic maxillary mega-antrostomy in recalcitrant maxillary sinusitis. Maxillectimy is not a difficult procedure and provides good visibility of the operative field. Otolaryngol Clin North Am.

Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

Six patients had prior Caldwell-Luc surgery. The patient received parenteral antibiotics during his or her stay in the hospital usually 24 hours and was discharged on oral medications.

Adult patients with tumors of the head but outside the sinonasal region were selected for the study. The lateral anterior side of the nasolacrimal duct recessus prelacrimalis was especially visible, being rarely observed in the Caldwell-Luc approach.


MRI T1 Gd-DTPA shows secondary maxillary sinusitis and a serpentine cerebriform filamentous structure, but there is no mass to otherwise indicate a possible origin. Similarly, the position of the most posterior portion of the nasolacrimal canal was identified on the axial reconstructions, and a mark was drawn 2 mm posterior to this.

The patient gave her consent. What role do systemic corticosteroids, immunotherapy, and antifungal drugs play in the therapy of allergic fungal rhinosinusitis?

Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

When there was a large ostium, 0. The frontal and maxillary sinuses were opened wide, while the posterior ethmoidal sinus was not opened. Our study is an attempt to define this subset of patients and a protocol for the treatment of these patients see Fig.

Lacrimation and empty nose syndrome do not occur postoperatively as the nasolacrimal duct and inferior turbinate are preserved. Using backbiting forceps, the antrostomy is widened anteriorly. Patients with AFRS were started on oral steroids, which were gradually tapered. Since IP was found at biopsy, she was referred to our hospital in order to undergo surgery.

Table of Contents Alerts. A CT scan of the paranasal sinus revealed a shadow that occupied the maxillary sinus and deviated to the ethmoidal sinus and a defect in the posterior wall and medial bone of the maxillary sinus Figure 2.

Subsequently, on the axial reconstructions, the borders of the maxillary sinus in the bony windows were manually outlined above and below this level on contiguous axial CT cuts.

The lacrimal process of the inferior turbinate, the frontal process of the maxilla, and the inferior portion of the lacrimal bone were maxillecomy with a 2. A canine fossa antrostomy is made, and the opening is widened using bone nibbler. Sixteen patients had history of previous surgery. Type I Modified Endoscopic Medial Maxillectomy The procedure media removal of intervening tissue between the two windows.


Visibility and resectability are different. The levels of SCC antigen had decreased to 2.

Endoscopic medial maxillectomy with preservation of inferior turbinate and nasolacrimal duct.

Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts. Conclusions Though many would be reluctant to advocate a radical surgery like a medial maxillectomy for persistent maxillary sinusitis, it is imperative to understand the physiology and its alteration following surgery and chronic infection, which leads to a radical change in the functioning capacity of the mediwl sinus.

November 1, ; final revision received June 17, ; accepted June 25, The procedure involves removal of intervening tissue between the two windows.

These patients are still symptomatic due to recirculation phenomenon where there is circular movement of the mucous around the artificially created window. Please review our privacy policy.

On the coronal reconstructions, the most superior insertion of the inferior turbinate to the lateral nasal wall was marked. Our website uses cookies to enhance maxillectoy experience.

Resection anterior to this structure will foster visualization.