CT Findings of Change of the Maxillary Sinus after Caldwell-Luc Operation

Im, Ju Hyeon; Kim, Sun Su; Kim, Jong An; Moon, Un Hyeon; Kang, In Young; Ko, Kang Seok; Kim, Se Jong; Park, Byung Ran; Kim, Byung Geun

doi:10.3348/jkrs.2000.42.3.431

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“…The changes in the maxillary sinus CT after the CL procedure have been described. The characteristic findings include bony defects in the anterior and medial sinus walls, osseous thickening, mucosal proliferation, sinus retraction, and cavity volume reduction [11,12]. In the present case, the CT scan revealed the typical image presentation that is mentioned above, except for inflammatory mucosal thickening of the left maxillary sinus.…”

Section: Discussionsupporting

confidence: 64%

“…Since the superiority of FESS to CL procedure in many aspects, such as better patient's comfort, less intraoperative and postoperative hemorrhage, fewer perioperative complications, and shorter recovery time, the CL procedure is seldom performed today and only indicated for limited cases with maxillary sinus disease [9,10]. In addition, CL surgery could lead to profound postoperative changes of the sinonasal structures and increase difficulty of subsequent surgery [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Surgical and Anatomic Consideration in Endoscopic Dacryocystorhinostomy of a Patient with Damaged Sinonasal Anatomy Post–Caldwell-Luc Surgery: A Case Report

et al. 2022

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Background: The Caldwell-Luc (CL) procedure, an outdated operative procedure that is used to treat inflammatory sinus diseases, is rarely performed presently. However, physicians may encounter patients with a history of CL surgery who develop considerable postoperative changes that may lead to diagnostic confusion in imaging evaluation; increase the difficulty of future surgery, such as sinonasal surgery; and increase the incidence of future intraoperative complications. Case summary: A 67-year-old man with a surgical history of chronic sinusitis reported epiphora of the left eye for five years. Balloon dacryocystoplasty was attempted but failed. Endo-DCR (Endoscopic dacryocystorhinostomy) was indicated; however, preoperative CT (computed tomography) imaging and nasal endoscopic examination showed sinonasal anomalies and the loss of internal landmarks for localizing the lacrimal sac. Preoperative CT results indicated previous CL surgery. Endo-DCR was performed with the aid of nasal forceps and a 20-gauge vitreoretinal fiberoptic endoilluminator. A six-month follow-up revealed the complete resolution of symptoms and no signs of recurrence. Conclusions: Epiphora might be a delayed complication of the CL procedure. Before performing endo-DCR, ophthalmologists should be familiar with the sinonasal anatomy and carefully assess preoperative imaging to identify anatomical variations. Nasal forceps and transcanalicular illumination can assist in determining the precise location of the lacrimal sac during endo-DCR.

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Section: Discussionsupporting

confidence: 64%