Vol.95 No.7 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 95 No. 7 July 2002
Approach to Maxillary Lesions
Kentaro Ochi, Natsuki Sugiura, Yasushi Komatsuzaki,
Takehiko Kobayashi and Susumu Saito
(St. Marianna University Toyoko Hospital)
Shoji Watanabe
(St. Marianna University)
First, we evaluated the patency of inferior meatal antrostomy for the treatment of maxillary lesions. Patients were followed for at least one year, with a mean follow-up duration of 23.3 months. There was no closure observed in 22 procedures. Secondly, we reported three cases of maxillary lesions. Recurrent mucosal lesions of antrochoanal polyps were successfully treated using a micro-debrider through the trocar at the canine fossa, while monitoring via the middle meatal window. A dental foreign body in the maxillary sinus was removed through the inferior meatal window, while monitoring via the trocar at the canine fossa. Blow-out fracture was successfully treated using canine fossa and inferior meatal approaches. An inferior meatal approach is useful postoperatively as well as intraoperatively. It is also useful when recurrent maxillary lesion is expected. A canine fossa approach is useful for improving intraoperative procedure without necessitating the use of special instruments. A canine fossa approach using the trocar is useful because it is minimally invasive for the patient. It can be safely concluded from the present results that the surgeon should choose the appropriate approach (or combine two or three approaches) for each maxillary lesion after considering several factors, including the general condition and bone structure of the patient, patient age, the location of the lesion and the treatment required, anesthesia, instrumentation availability at the institute, the skill of the surgeon, and the expected postoperative status.
Key words : maxillary lesion, patency, inferior meatal antrostomy, trocar, canine fossa approach