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Medial maxillectomy in recalcitrant sinusitis: when, why and how?

Konstantinidis, Iordanis; Constantinidis, Jannis

Current Opinion in Otolaryngology & Head and Neck Surgery: February 2014 - Volume 22 - Issue 1 - p 68–74
doi: 10.1097/MOO.0000000000000009
NOSE AND PARANASAL SINUSES: Edited by Samuel S. Becker and Nithin D. Adappa

Purpose of review We reviewed all journal articles relevant to endoscopic medial maxillectomy in patients with recalcitrant chronic maxillary sinusitis in order to present all indications, the underlying pathophysiology and the developed surgical techniques.

Recent findings Despite the high success rate of middle meatal antrostomy, cases with persistent maxillary sinus disease exist and often need a more extended endoscopic procedure for the better control of the disease. Such surgical option uses gravity for better sinus drainage and offers better saline irrigation, local application of medications and follow-up inspection. An endoscopic medial maxillectomy and its modified forms offer a wider surgical field and access to all ‘difficult’ areas of the maxillary sinus.

Summary Patients with previous limited endoscopic sinus surgery or extended open surgery, cystic fibrosis, extensive mucoceles, allergic fungal sinusitis, odontogenic infections, foreign bodies and so on may suffer from recurrent disease requiring an endoscopic medial maxillectomy. Depending on the disease, various modifications of the procedure can be performed preserving the anterior buttress, nasolacrimal duct and inferior turbinate if possible.

2nd Academic ORL Department, Aristotle University, Papageorgiou Hospital, Thessaloniki, Greece

Correspondence to Jannis Constantinidis, 2nd Academic ORL Department, Aristotle University, 24 Adrianoupoleos str, Kalamaria, Thessaloniki 55133, Greece. Tel: +302313323525; fax: +306944346056; e-mail:

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