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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The patient was free from recurrence 3 months after the surgery Figure 4.

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

Analysis and interpretation of data: A retrospective case series of six patients with IP and nine patients with mucoceles of the maxillary sinus after a Caldwell-Luc operation, who underwent surgery using the EMMM technique, were reviewed.

Nineteen patients with no radiographic evidence of sinonasal disease or neoplasia were identified. Therefore, in these approaches, intraoperative access to the anterior and lateral walls of the maxillary sinus is limited.

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Case Reports in Otolaryngology

Woodworth et al reported in a retrospective review comprising 19 patients that MEMMs are both safe and an effective treatment for chronic maxillary sinusitis refractory to standard medical and endoscopic surgical management. This subset of patients often has persistent sinus disease despite sndoscopic therapy and adequate antrostomy. Other surgeons have also cited tumors involving the anterior, inferior, or lateral maxillary sinus as limitations to the endoscopic approach.

Resection of the lateral nasal wall to the inferior meatus and anteriorly to include the nasolacrimal canal is required for proper access to the maxillary sinus during transnasal endoscopic medial maxillectomy.


The central dogma of functional endoscopic sinus surgery is restoration of the natural sinus physiology, namely mucociliary clearance and ventilation. Delayed dye movement indicates that there is a certain degree meedial mucociliary clearance that, despite being present, is inadequate to prevent recurrent infection of the sinus.

Type III involves widening it close to the level of the posterior wall of the maxillary antrum and anterior to the lacrimal sac and inferiorly to the base of the inferior turbinate.

These patients would require removal of secreting mucosa in addition to MEMM. 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.

No movement of dye indicates irreversible loss of ciliary function and hence a simple widening of the already widened ostium i.

However, ESS is not a good choice for tumors that originate from the anterior and maxjllectomy walls of the maxillary sinus. When there was a large ostium, 0. She was diagnosed as having a nasal polyp.

Delayed clearance of dye; allergic fungal rhinosinusitis. The lateral anterior side of the nasolacrimal duct recessus prelacrimalis was especially visible, being rarely observed in the Caldwell-Luc approach. Edoscopic of endoscopic maxillary mega-antrostomy in recalcitrant maxillary sinusitis.

Create a free personal account maxillecgomy download free article PDFs, sign up for alerts, customize your interests, and more. 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.


This is performed for patients with delayed dye clearance. Privacy Policy Terms of Use. ESS is often selected as an appropriate procedure for surgical treating IP [ 10 ]. Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your fndoscopic account. The anterior, inferior, and medial walls of the maxillary sinus could be observed endoscopically. 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 enoscopic described hitherto.

The technique and exposure are similar to the open medial maxillectomy, except for the lamina papyracea and anterior maxillary wall that are preserved with TEMM. The surgical procedure is selected based on the Krouse staging system and the ,edial of origin of the tumor.

Received Sep 27; Accepted Dec To receive news and publication updates for Case Reports in Otolaryngology, enter your email address in the box below.

Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

As familiarity and expertise with endoscopic techniques increase, these approaches are being used more frequently in the extirpation of sinonasal tumors. Postoperative observation of nasal cavity.

Ponnaiah Thulasidas 1 and Venkatraman Vaidyanathan 2.

Four patients had AFRS, one of whom had been previously operated on. Otolaryngol Clin North Am.