Article Type
Article
Abstract
Introduction: Extensive disease in the maxillary sinus is difficult to clear with standard instrumentation during traditional endoscopic sinus surgery, so access to the anterior and anterolateral walls of the maxillary sinus is often difficult despite the creation of a large maxillary antrostomy or the use of adjuvant surgical procedures such as canine fossa puncture to gain improved access and allow for good debridement of maxillary sinus.
Objective: To study the outcome of prelacrimal approach compared with canine fossa approach (CFA) for surgical treatment of anterior maxillary sinus diseases.
Patients and methods: A randomized prospective clinical study, in which 40 patients with recurrent anterior maxillary sinus lesion were divided into two equal groups: group I included 20 patients who underwent endoscopic prelacrimal recess approach (PLRA), and group II included 20 patients who underwent endoscopic CFA. Patients were evaluated between February 2018 and October 2019. The two groups were compared regarding facial pain, facial numbness, cheek swelling, nasal obstruction, epiphora, inferior turbinate destabilization, inferior turbinate‑nasolacrimal duct flap status, crustations, synechiae, bleeding, infection, and antrochoanal polyp recurrence.
Results: Operation time was significantly longer in CFA group II (38 min) compared with PLRA group I (27 min) (P<0.001). Cheek swelling was significantly higher in CFA group in comparison with PLRA group (P<0.001). Facial numbness and facial pain were significantly higher in CFA group compared with PLRA group at 1 week postoperatively (P=0.047 and 0.025, respectively).
There were no significant differences between both groups regarding type of lesion and recurrence (P=1.0 for each).
Conclusion: PLRA is a safe and simple technique for manipulation of anterior maxillary sinus lesions with short operative time and minimal postoperative complications.
Keywords: Canine fossa approach and endoscopic sinus surgery, maxillary sinus, prelacrimal recess approach.
Recommended Citation
Kamel SB, Gad HA, Abdelazeem HM,
et al.
Prelacrimal versus canine fossa approach for anterior maxillary sinus lesions.
Pan Arab J. Rhinol.
2020;
10 : 118-126.
Available at:
https://pajr.researchcommons.org/journal/vol10/iss2/13
DOI: https://doi.org/10.4103/pajr.pajr_15_20
