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Caldwell-luc antrostomy is an operation to remove irreversibly damaged mucosa of the maxillary sinus. It is done when maxillary sinusitis is not cured by medication or other non-invasive technique.The approach is mainly from anterior wall of maxilla bone.
It is rarely done in children as the damage to secondary dentition may occur.
Operation may be performed under local anaesthesia but it is commonly carried under general anaesthesia. The use of topical anaesthesia and injection of adrenaline into soft tissue of canine fossa is recommended.
First of all the incision is made from lateral incisor to the second molar tooth.Then the flap of mucosa and periosteum is elevated and dissected to expose the anterior wall of sinus and then anterior wall is opened in the canine fossa where the bone is relatively thin with the drill. The opening can be enlarged by hayek or kerrison punch forceps to produce hole sufficiently large to provide access for example to allow removal of sinus mucosa or introduction of an endoscope and instruments.
The entire lining of sinus is dissected and removed as the success of the operation in chronic rhinosinusitis. Packing of nasal cavity and sinus is sometime required. Suturing of buccal incision is recommended with absorbable suture material.
The patient should be advised against overenthusiastic blowing of the nose for at least a week.
It was described by George Caldwell in 1893 and Henry Luc in 1897. They describe the operation of maxillary sinus diseases via canine fossa.Functional endoscopic sinus surgery is the standard surgery for maxillary sinusitis nowadays.
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