Medical College of Wisconsin
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Surgical revision of the post-Caldwell-Luc maxillary sinus. Am J Rhinol 2005;19(5):478-82

Date

11/08/2005

Pubmed ID

16270602

Scopus ID

2-s2.0-27944462252 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

BACKGROUND: Endoscopic sinus surgeons are commonly faced with the management of patients with persistent maxillary sinusitis despite previous Caldwell-Luc surgery. Given the potential for altered mucociliary clearance in the post-Caldwell-Luc maxillary sinus, the optimal approach for surgical revision has not been well characterized. The objective of this study was to review our experience in endoscopic versus repeat Caldwell-Luc approaches in patients who have failed Caldwell-Luc surgery for chronic maxillary sinusitis.

METHODS: Retrospective chart review was performed on patients who had a history of a Caldwell-Luc procedure and who then underwent a surgical revision for persistent maxillary sinusitis at the Oregon Health and Science University and Medical College of Wisconsin between 1983 and 2002.

RESULTS: Sixty-eight patients were identified, with a total of 156 revision procedures performed on 103 maxillary sinuses. Fifty-three percent of the sinuses underwent endoscopic maxillary antrostomy as the first surgical revision, while 47% underwent a revision Caldwell-Luc procedure. Sixty-seven percent of the sinuses in the revision endoscopic group had clinical resolution with a single surgical revision, and 60% of the sinuses in the revision Caldwell-Luc group had clinical improvement with one surgical revision (p = 0.46). The endoscopic group averaged 1.3+/-0.5 revision procedures per sinus to achieve clinical resolution, and the revision Caldwell-Luc group averaged 1.7+/-1.0 revision procedures per sinus (p = 0.3). Mean follow-up was 25 months.

CONCLUSION: Endoscopic revision of the maxillary sinus yields comparable outcomes to repeat Caldwell-Luc procedure in patients with a history of previous failed Caldwell-Luc surgery. Endoscopic revision surgery is a viable alternative for surgical rehabilitation of the post-Caldwell-Luc maxillary sinus.

Author List

Han JK, Smith TL, Loehrl TA, Fong KJ, Hwang PH



MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Chronic Disease
Endoscopy
Female
Humans
Male
Maxillary Sinus
Maxillary Sinusitis
Middle Aged
Otorhinolaryngologic Surgical Procedures
Reoperation