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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Inverted papilloma could be resected with highly curved forceps. Introduction The central dogma of functional endoscopic sinus surgery is restoration of the natural sinus physiology, namely mucociliary clearance and ventilation.

The mean Mazillectomy V5 was Four patients had endsocopic balls, and one patient had chronic indolent fungal sinusitis. The CT did not reveal localized thickening of the bone, and the MRI did not show secondary changes in the maxillary sinus or a distinctive mass of serpentine cerebriform filamentous structure Figure 2.

Endoscopic medial maxillectomy is a radical procedure that includes removal of uncinate process, bulla, inferior turbinate, middle turbinate, and medial maxillary wall with the nasolacrimal duct.

The patient had mild numbness around the lips, but no symptom in the eyes, such as lacrimation. Patients with AFRS were started on oral steroids, which were endosdopic tapered. Sinonasal inverted papillomas IPs are one of most commonly found benign tumors in the paranasal sinuses [ 1 ]. Get free access to newly published articles Create a personal account or sign in to: 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 maxillary sinus.


Krouse suggested a staging system based meidal the range of IP and further suggested the procedures that should be selected for IP at different stages [ 4 ]. maxillectom

It should be noted that we do not perform the dye test in patients with fungal balls or polyps in the maxillary sinus, as the mucosa is deemed abnormal.

In order to prevent recurrence, IP must be totally resected using a microdebrider, suction, or cutting forceps. It is important to note that these patients have been operated on previously with varying degrees of damage to the mucous membrane.

Intraoperatively, adjacent tissue can be closely examined with endoscopy and, if uninvolved, can be spared. Modified endoscopic medial maxillectomy, nasolacrimal duct preserved, maxillary sinus mucosa stripped off by through an antral window. All patients underwent a diagnostic nasal endoscopy.

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

Case Reports in Otolaryngology

The drainage media, the sinus is by gravity. Abnormal dye test indicating disease of maxillary sinus mucosa. However, ESS is not a good choice for tumors that originate from the anterior and inferior walls of the maxillary sinus. No malignant finding was obtained. Revision functional endoscopic sinus surgery aims to overcome these shortcomings but can fall short due to irreversible damage to the mucous membrane by prior surgery.

This technique is an effective, reproducible technique for treatment of sinonasal tumors and other aggressive disease processes. All patients showed preservation of the inferior turbinate. A wide middle meatal antrostomy is usually sufficient in patients with normal movement of dye. Results of endoscopic maxillary mega-antrostomy in recalcitrant maxillary sinusitis.


Cadaveric resection of the lateral nasal wall via transnasal endoscopic medial maxillectomy demonstrating the defect and specimen. The inferior turbinate was found in its inherent position. Sixteen patients had history of previous surgery. Intraoperative transnasal endoscopic view.

Coronal T1-weighted magnetic resonance image with gadolinium of the same patient as shown in Figure 4showing the maxillary sinus floor extending below the level of the nasal floor. The anterior endoscopiic of dissection is the nasolacrimal duct. The patient refused to undergo lateral rhinotomy and was therefore informed that ESS and EMMM procedures would be used concomitantly and that a transantral approach TAColdwell-Luc surgery, would be used if necessary.

Both V4 and V1 carry a relatively normal distribution Figure 1 and Figure 2. We selected EMMM because it allows for the preservation endoscoipc the physiological function of the nose. The inferior turbinate has a critical function in conditioning of the nasal airflow, and resection of the nasolacrimal ducts has a risk of epiphora. Privacy Policy Terms of Use.

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

Postoperative observation of nasal cavity. The average age was They recommend type III for extensive sinus disease, antrochoanal polyp removal, and previous surgery. The patient was free from recurrence 3 months after the surgery Figure 4. Other surgeons have also cited tumors involving the anterior, inferior, or lateral maxillary sinus as limitations to the endoscopic approach. This is done in medjal with a prior inferior meatal antrostomy and a middle meatal antrostomy Caldwell-Luc. Case Reports in Otolaryngology.