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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The causes for failure include mucosal, environmental, and iatrogenic factors.

Copyright American Medical Association. The technique and exposure are similar to the open medial maxillectomy, except for the lamina papyracea and anterior maxillary wall that are preserved with TEMM.

Case Reports in Otolaryngology

Statistical analysis was performed, and mean, median, and standard deviation of these values were calculated using SPSS statistical software version Inverted papilloma could be resected with highly curved forceps. All patients showed preservation of the inferior turbinate. Table 2 Patient details.

Type I Modified Endoscopic Medial Endodcopic The procedure involves removal of intervening tissue between the two windows.

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

Six patients had prior Caldwell-Luc surgery. Iatrogenic factors involve inadvertent stripping of sinus mucosa, damage to the cilia bearing mucosa with the microdebrider or other instruments, exposure of bone, circumferential damage to the sinus ostium, improper widening of sinus ostium permitting recirculation of mucous, poor mucociliary clearance, among others. Preoperative CT scan is mandatory in all patients undergoing revision sinus surgery as it defines the bony anatomy or rather the loss of it due to previous surgery well.


An endoscopic and tomographic evaluation of patients with sinusitis after endoscopic sinus surgery and Caldwell-Luc operation: When no movement of the dye at all could be seen, the result was noted.

Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

Journal List Int Arch Otorhinolaryngol v. Three patients had osteomyelitis of the maxilla due to prior surgery or fungal infection.

The mean SD V4 was The goals of surgery are threefold: 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.

Get free access to newly published articles Create a personal account or sign in to: Ednoscopic, the dye could also be instilled into the sinus through a trocar in the canine fossa.

A good visibility could be achieved and the tumor deviating to the inferior meatus could be sufficiently resected without any problems. Case Presentation A year-old woman visited an emdial with 5-year history of nasal congestion. Discussion Medial maxillectomy through a lateral rhinotomy incision involves the mxxillectomy of the lateral nasal wall, ethmoid labyrinth, and medial portion of the maxilla. Sign in to customize your interests Sign in to your personal account.


The senior author N. Management of recurrent sinus disease in children with cystic fibrosis: Create a free personal account to access your subscriptions, sign up for alerts, and more.

The pyriform aperture and the mucosa of the inferior turbinate were sutured and the surgery was completed. We have attempted to highlight this point through this article. The patient gave maxillectommy consent.

Therefore, volumetric analysis of 38 maxillary sinuses was performed. It is also understood that the origin of the tumor is very important. In endoscopic surgery, it is important meial identify the origin of the maxillectommy and the surgical margin, by piecemeal resection and debulking surgery [ 8 ]. The inferior turbinate and the nasolacrimal duct could be preserved because they could be moved medially, which prevented lacrimation or empty nose syndrome, with a good postoperative clinical course.

Radical medial maxillectomy is reserved for maxillary sinus tumors, which falls outside the range of discussion in this article.