Application of the endoscopic prelacrimal recess approach to the maxillary sinus in unilateral maxillary diseases

Abstract

Patients who underwent surgery via the prelacrimal recess approach did so mostly because tumors were present in the maxillary sinuses (12/15; 80%), while most of the patients in this study underwent surgery because of chronic inflammation (122/177; 68.9%) and fungal infections (40/177; 22.6%). Among 15 patients undergoing surgery via the prelacrimal recess approach, 9 were cases of inverted papilloma. The mean follow-up period was 16.5 months (range, 6 to 28 months). No postoperative complications occurred after the prelacrimal recess approach. One out of the 15 cases undergoing the prelacrimal recess approach had tumor recurrence CONCLUSION: Most chronic inflammation and fungal infections of the unilateral maxillary sinuses can be managed through a middle meatal antrostomy. The endoscopic prelacrimal recess approach is a reliable and effective method used to approach maxillary sinus diseases.

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

“…Bertazzoni et al (2017), using extended endoscopic maxillectomies exclusively, also found significantly greater number for sensory deficits and esthetic problems than Zhou et al (2018) reported. Three studies of EPLA SNIPs resections in relatively small patient groups have recently reported EPLAs to result in favorable local control rates, though they did not investigate post-surgery quality-of-life (Lee et al, 2019;Yu et al, 2018;Lin, Lin & Yeh, 2018). Our eight sinonasal papillomas patients reported a median SNOT-22 score of eight after resection, slightly lower than the scores reported by a previously reported case series (Harrow & Batra, 2013).…”

“…In the surgical treatment of diseases originating from different sites of the maxillary sinus, the endoscopic pre-lacrimal approach makes possible the management of almost any aspect of internal linings. Especially the anterior and inferior aspect (e.g., alveolar recess and PLR), which are locations that traditional surgical corridors can hardly access (Nakamaru et al, 2010;Zhou et al, 2013Zhou et al, , 2016Lee et al, 2019;Zhou et al, 2018;Yu et al, 2018;Lin, Lin & Yeh, 2018). In select cases in which disease is located far laterally, surgeons can drill the pyriform aperture and/or part of anterior maxillary wall to extend surgical fulcrum (Turri-Zanoni et al, 2017;Nakamaru et al, 2010;Zhou et al, 2013).…”

“…The use of the EPLA has been reported to provide results comparable to those of conventional external procedures (Lee et al, 2019). However, its application has mostly been focused on the removal of neoplasms and no studies have been performed to assess post-treatment life-quality following EPLA (Lee et al, 2019;Zhou et al, 2018;Yu et al, 2018;Lin, Lin & Yeh, 2018). Therefore, in this study, we retrospectively reviewed the clinical applications of endoscopic PLR approach in the surgical treatment of different maxillary pathologies.…”

Intranasal endoscopic prelacrimal recess approach for maxillary sinus inverted papilloma

“…The bone hyperplasia in the basal part of the tumor needs to be removed with a bone chisel or drill [16]. The occurrence of adverse reactions must be avoided during surgery [17]. The PLRA achieves the exposure range of medial maxillectomy and the Caldwell-Luc surgery, and retains the integrity of the IT and lacrimal duct system.…”

Endonasal Approaches to Maxillary Sinus

“…7). [26][27][28][29] Typically, it involves a vertical incision at the front o f the inferior turbinate on the lateral wall of the nose. After raising a mucosal flap over the bone, the medial maxillary wall can then be entered anterior to the nasolacrimal duct using an osteotome or drill.…”