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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Volumetric calculations of each of these 3-dimensional spaces were performed by the software. Inverted papilloma could be resected with highly curved forceps.

Three patients had osteomyelitis of the maxilla due to prior surgery or fungal infection. Inverted papilloma may ejdoscopic malignant or complicated with cancer [ 23 ] and complete surgical resection is therefore essential for treatment.

All procedures were done under general anesthesia. The surgery was performed under general anesthesia.

Transnasal endoscopic medial maxillectomy provides exposure for endoscopic resection of the maxillechomy wall, pterygopalatine fossa, pterygoid plates, nasopharynx, and anterior skull base when indicated.

The sinus has to work against gravity to expel its waste material, which is the single most important factor in the production of recalcitrant sinusitis that does not respond to surgical methods described hitherto.

Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

Distribution of maxillary sinus volume inferior to the attachment of the inferior maxillectony for 38 maxillary sinuses. Abnormal dye test indicating disease of maxillary sinus mucosa.

Transnasal endoscopic medial maxillectomy in inverted papilloma.

Modified endoscopic medial maxillectomy for maxilleftomy maxillary sinusitis. It has the advantages of excellent exposure of the lateral nasal wall and paranasal sinuses.

Note that the middle turbinate, nasolacrimal duct, and anterior portion of the inferior turbinate are preserved Fig. In endoscopic surgery, it is important to identify the origin of the tumor and the surgical margin, by piecemeal resection and debulking surgery [ 8 ]. Medial maxillectomy, with either an open or endoscopic approach, should allow for resection of the maxillary and ethmoid sinuses, along with the entire lateral nasal wall.


Volumetric measurements were performed with axial images 2.

Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

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. Create a personal account to register for email alerts with links to free full-text articles.

As the nasolacrimal duct could be clearly observed by endoscope, the tumor deviating to the inferior meatus and the lateral mucosa and the bony wall of the inferior meatus could be sufficiently resected.

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The lateral anterior side of the nasolacrimal duct recessus prelacrimalis was especially visible, being rarely observed in the Caldwell-Luc approach.

Based on the ciliary movement and nasal endoscopy findings, we advocate three solutions to resolve the problem.

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

We are of the opinion that the mucociliary clearance is the single most important factor in determining the outcome in maxillary sinus after surgery. Create a free personal account to download free article PDFs, sign up for alerts, and more. Our patient had a wide tumor origin, bone defects, and high preoperative levels of SCC antigen.

Bringing the medial maxillary wall to the level of the nasal floor appears to alleviate symptoms in these patients. Manual of endoscopic sinus surgery and its extended applications; pp. An endoscopic and tomographic evaluation of patients with sinusitis after endoscopic sinus surgery and Caldwell-Luc operation: Statistical analysis was performed, and mean, median, and standard deviation of these values were calculated using SPSS statistical software version Krouse suggested a staging system based on the range of IP and further suggested the procedures that should be selected for IP at different stages [ 4 ].


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

Introduction Sinonasal inverted papillomas IPs are one of most commonly found benign tumors in the paranasal sinuses [ 1 ]. Slightly posterior to the pyriform aperture, the mucosa was incised from the superior portion of the inferior turbinate towards the nasal floor, and the nasal mucosa was elevated from the lateral wall of the nasal cavity.

Delayed dye movement indicates that there is a certain degree of mucociliary clearance that, despite being present, mmaxillectomy inadequate to prevent recurrent infection of the sinus. Middle meatus and inferior meatal windows joined, creating a mega ostium, inferior turbinate partially resected.

The levels of SCC antigen had decreased to 2. The CT did not reveal localized thickening of endosopic bone, and the MRI did not show secondary changes in the maxillary sinus or a distinctive mass of serpentine cerebriform filamentous structure Figure 2. Resection of the lateral nasal wall to endosopic level of the inferior meatus and anteriorly beyond the nasolacrimal canal is required to gain full access to the maxillary sinus during endoscopic medial maxillectomy.

Both V4 and V1 carry a relatively normal distribution Figure 1 and Figure 2. At present, there are no definitive guidelines for the treatment of this subset of patients. The areas that may offer difficulty include the sinus recesses and the anteromedial wall.

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