Endoscopic-modified medial maxillectomy for the nonfunctioning maxillary sinus

Kachorn Seresirikachorn*, Lu Hui Png, Mickey Kondo, Larry Kalish, Raewyn G. Campbell, Raquel Alvarado, Richard J. Harvey

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Background: Middle meatal antrostomy (MMA) is the traditional intervention for chronic maxillary sinusitis but often fails to correct a nonfunctioning maxillary sinus that has lost its capability for mucociliary clearance. Endoscopic-modified medial maxillectomy (EMMM) can reshape the maxillary sinus and avoid a “sumping” effect, preventing secondary bacterial colonization, encouraging dependent drainage, and promoting effective nasal irrigation. Objectives: We describe a modification of the EMMM surgical technique in patients with recalcitrant maxillary sinusitis and perioperative outcomes. Methods: Consecutive adult patients with nonfunctioning maxillary sinuses managed with EMMM were assessed. Primary outcomes were the resolution of the presenting symptom and the absence of mucostasis. Secondary outcomes were early (<90 days) and late (>90 days) morbidity. Results: Fifty-seven patients (51.7 ± 17.5 years, 56.1% female) were assessed. Fifty-two patients had complete resolution of their presenting symptom (91.2% [95% CI: 80.7–97.1]) and 52 patients had an absence of mucostasis (91.2% [95% CI: 80.7–97.1]). Those with persistent crusting were also those with symptoms. Early morbidities included temporary dysesthesia (3.2%), bleeding (1.1%), and pain (3.2%), with no late morbidities. Conclusion: EMMM is a robust approach for salvaging a nonfunctioning maxillary sinus. The procedure enhances nasal irrigation, supplants mucociliary clearance, and discourages dependent mucus retention.

Original languageEnglish
Pages (from-to)611-615
Number of pages5
JournalAmerican Journal of Rhinology and Allergy
Volume37
Issue number5
DOIs
Publication statusPublished - Sept 2023

Keywords

  • chronic maxillary sinusitis
  • endoscopic endonasal surgery
  • endoscopic nasal and sinus surgery
  • maxillary sinus
  • maxillary sinusitis
  • modified medial maxillectomy
  • nonfunctioning maxillary sinus disease
  • paranasal sinus diseases
  • recalcitrant maxillary sinusitis
  • salvage sinus surgery

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