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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Drafting of the manuscript: Inverted endoscopuc may become malignant or complicated with cancer [ 23 ] and complete surgical resection is therefore essential for treatment. One patient with mucocele was referred for dacryocystorhinostomy because of epiphora. The patient gave her consent. The inferior turbinate has a critical function in conditioning of the nasal airflow, and resection of the nasolacrimal ducts has a risk of epiphora.

Type Indication Procedure I Recirculation mechanism due to two windows in middle meatus and inferior meatus e.

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

All of the IPs were adhering to the posterior wall. The patient had mild numbness around the lips, but no symptom in the eyes, such as lacrimation. Others 16 have supported this notion that an endoscopic medial maxillectomy is completed only with resection of the medial wall of the maxilla including the inferior turbinate up to its anterior wall.

Within each patient’s scan, left and right sinuses were considered individually. Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more. Hence we feel we are justified in performing a procedure aimed at providing gravity-dependent drainage for the sinus.

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Sign in to make a comment Sign in to your personal account. As shown in a cadaveric resection in Figure 3 and an endoscopic maxilleftomy of the maxillary sinus following TEMM in Figure 4TEMM allows for a wide view of endoxcopic posterior, anterior, lateral, inferior, and superior borders of the maxillary sinus.

The average age was A wide middle meatal antrostomy is usually sufficient in patients with normal movement of dye.

Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

An endoscopic and tomographic evaluation of patients with sinusitis after endoscopic sinus surgery and Caldwell-Luc operation: With this wide exposure, extended endonasal endoscopic approaches can be employed for resection of tumors or other diseases that go beyond the maxillary sinus. Images with evidence of any sinonasal disease inflammatory or neoplastic were excluded from the study.

All patients underwent a preoperative computed tomography CT scan and surgical profile. Maxillechomy patients have multiple windows for drainage, namely, an inferior antrostomy and a middle meatal antrostomy. When there was a large ostium, 0. Type I Modified Mefial Medial Maxillectomy The procedure involves removal of intervening tissue between the two windows.

Critical revision of the manuscript for important intellectual content: Conclusions Though many would be reluctant to advocate a radical surgery like a medial maxillectomy for persistent maxillary sinusitis, it is imperative to media, the physiology and its alteration following surgery and chronic infection, which leads to a radical change in the functioning capacity of the maxillary sinus. These patients had undergone multiple endkscopic surgeries elsewhere or in our center in the past but were still symptomatic.


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. Alternatively, the dye could also be instilled into the sinus through a trocar in the canine fossa. In case of inadvertent injury, it should be transposed higher, near the attachment of the middle turbinate Fig.

En bloc specimen after transnasal endoscopic medial maxillectomy.

Details of the surgery are described in the Surgical Method section. A year-old woman visited an otorhinolaryngologist with 5-year history of nasal congestion.

Four patients had fungal balls, and one patient had chronic indolent fungal sinusitis. The nasolacrimal duct should be identified and preserved.

Case Reports in Otolaryngology

The technique and exposure are similar to the open medial maxillwctomy, except for the lamina papyracea and anterior maxillary wall that are preserved with TEMM. Received Sep 27; Accepted Dec All patients underwent a diagnostic nasal endoscopy. Our patient had a wide tumor origin, bone defects, and high preoperative levels of SCC antigen. We have attempted to highlight this point through this article.