[Surgical maxillary sinus restoration--a routine procedure?].

Abstract

Between the years 1973-1979 173 operations were carried out at the ORL-Hospital Oldenburg for the rehabilatation of the maxillary sinus. Primary, only 48 patients had indications of Caldwell-Luc radical operation by either purulent or purulent-polypous sinusitis, but 43 cases were operated again because of different complications after primary operation in other hospitals. Due to this fact, the following questions were raised: 1. Were the indications to the intervention right? 2. What is the optimal technique of operation? 3. What are the reasons for complaints after the operation? Caldwell-Luc method is mainly used in tumors, dentigerous cysts, alveolar fistula and traumatic lesions, but in the case of purulent or purulent-polypous sinusitis, only after a very strong conservative treatment an endonasal approach is usually used at first. The operation by Caldwell-Luc must be performed very carefully and always together with a plastic of the anterior wall of the maxillary sinus. The complaints following a Caldwell-Luc operation are mainly due to a very small inferior nasal hole or a very large opening in the anterior wall of the maxillary sinus, that the new scar tissues cause irritation to the second trigeminal branch as well as the formation of a mucosal cyst after an incomplete mucous membrane exstirpation.