gms | German Medical Science

Maxillary sinus (MS) opening is one of the most common surgical procedures. For rhinological situations endonasal sinus intervention is more preferable. Microscopes and endoscopes can be used endonasaly, intervention can be performed trans middle meatus or rarely via inferior meatus with artificial window formation. Last years number of patients with dental indications for MS surgery highly increases. Most of these patients have no rhinological complains. CT examination made prior to tooth implantations and sinus lifting often detected pathological changes in maxillary sinus floor. These changes can be not significant for rhinology but important for implantology. In such cases, trans middle meatus approach is traumatic and technically difficult. Also this surgical strategy leads to destruction of physiological function of osteomeatal unit. Last 7 years we prefer inferiour meatus temporary approach without artificial window formation for maxillary sinus endoscopic surgery. Intervention can be performed in most cases under local anesthesia. After Hassner valve is identified, area of incision can be chosen and be performed with elevator. Osteo mucosal flap preparation depends on situation with prevention of lacrimal pathways damage and bony walls retraction. For maxillary sinus examination and removal of pathological tissues we use different angled endoscopes, or with changeable view directions. Required angle of instruments depends on situation. At the end of surgical procedure flap can be returned back to close gap of temporary approach and if necessary mucosa can be fixed by sutures. Postoperative period and care is easy, surgery can be performed in the office. Our experience shows the advantages of this approach as one of minimally traumatic methods of MS surgery.

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