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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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. Introduction Sinonasal inverted papillomas IPs are one of most commonly found benign tumors in the paranasal sinuses [ 1 ].

Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

When a tumor originates from a wide area, like that observed in our patient, it is important to use EMMM to allow the inside of the maxillary sinus to become visible, to control bleeding, to select forceps that can fully resect the lesion, and to ensure that the tumor has been fully resected. EMMM is not a difficult procedure and provides good visibility maxlllectomy the operative field.

We can deduce three conclusions from this test: They recommend type III for extensive sinus disease, antrochoanal polyp removal, and previous surgery. No Movement of Dye No movement of dye indicates irreversible loss of ciliary function and hence a simple widening of the already widened ostium i. All patients underwent a diagnostic nasal endoscopy. The goals of surgery are threefold: EMMM produces access to the maxillary sinus identically to conventional EMM, despite preservation of the inferior turbinate and nasolacrimal duct.


One patient with mucocele was referred for dacryocystorhinostomy because of epiphora. This allows for full access to the maxillary sinus, including the anterior and lateral walls, the ethmoid sinuses, and the anterior wall of the sphenoid sinus. Preoperative observation of nasal cavity. This is an open access article distributed under the Creative Commons Attribution Licensewhich permits endoscoplc use, distribution, and reproduction in any medium, provided the original work is properly cited.

Modified endoscopic medial maxillectomy for chronic maxillary sinusitis.

However, we consider ESS to be a viable option for treating tumors that maxilleectomy from the lateral side and the posterior wall of the maxillary sinus as ESS provides a good visibility of the operative field. A canine fossa antrostomy is made, and the opening is widened using bone nibbler.

Many of these lesions, including inverted maxilpectomy, have shown favorable outcomes with transnasal endoscopic resections. Endoscopic medial maxillectomy EMM is a safe and effective procedure for treatment of inverted papilloma IP originating from the maxillary sinus. The pyriform aperture and the mucosa of the inferior turbinate were sutured and the surgery was completed. Support Center Support Center.

The lateral anterior side of the nasolacrimal duct recessus prelacrimalis was especially visible, being rarely observed in the Caldwell-Luc approach. The purpose of this article is to share the cumulative experience kedial all the cases operated using this technique and to highlight the effectiveness of this technique in dealing with persistent maxillary sinusitis. Modified endoscopic medial maxillectomy for recalcitrant chronic maxillary sinusitis.

At present, there are no definitive guidelines for the treatment of this subset of patients. In this case, there was no thickening of the bony wall of posterior wall of the maxillary sinus. The patient received parenteral antibiotics during his or her stay in the hospital usually 24 hours and was discharged on oral medications.


Therefore, in these approaches, intraoperative access to the anterior and lateral walls of the maxillary sinus is limited.

Case Reports in Otolaryngology

She was diagnosed as having a nasal polyp. These patients had undergone multiple endoscopic surgeries elsewhere or in our center in the past but were still symptomatic. The medial wall of the maxillary sinus is removed right down to the nasal floor inferiorly and up to the posterior wall posteriorly.

Sign in to make a comment Sign in to your personal account. On the coronal mecial, the most superior insertion of the inferior turbinate to the lateral nasal wall was marked. Chronic sinusitis post—radiotherapy and chemotherapy. Some patients have multiple windows for drainage, namely, an inferior antrostomy and a middle meatal antrostomy.

Ponnaiah Thulasidas 1 and Venkatraman Vaidyanathan 2. Though the ciliary mechanism is lost, the goblet cells continue to secret mucus, which results in stasis, an additional factor.

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

The nasolacrimal canal prevents endoscopic visualization and access to the anterior maxillary sinus wall. The drainage of the sinus is by gravity. Since IP was found at biopsy, she was referred to our hospital in order to undergo surgery. As previously described by the senior author N.

Visibility and resectability are different. Inverted papilloma could be resected with highly curved forceps.