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Endoscopic maxillectomy: anatomo-radiological description of the “double” maxillary sinus window

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objectives/hypothesis

To present a modified endoscopic medial maxillectomy (MEMM) approach to control maxillary sinus pathologies.

Methods

MEMM was completed in 13 fresh-frozen specimens. An MEMM includes cutting the nasolacrimal duct, inferior meatus flap, and repositioning the inferior turbinate (IT). The following measurements were obtained: length of IT, height from the nasal floor to valve of Hasner, height of the IT at the level of valve of Hasner, height of the IT at the insertion of the middle turbinate, and distance from the piriform aperture to the posterior wall of maxillary sinus and to the posterior border of palatine bone. Similar measurements were also performed on craniofacial computed tomography (CT) scans (n = 50). The surgical technique was performed in a case series (n = 8).

Results

The mean of the specimens was 82 (range 70–95) years old. The average area of the harvested inferior meatus flap area was 9.6 ± 1.0 cm2. In the radiologic study, the mean maximum antrostomy area was 8.8 ± 1.7 cm2 and the IT area overlapping the antral window was 5.8 ± 1.1 cm2, the area allowing a double window control was 3.1 ± 1.9 cm2, the posterior IT insertion length was 0.7 ± 0.4 cm, and the inferior meatus flap covering the inferior meatotomy had an area measuring 6.7 ± 1.7 cm2. Eight patients underwent MEMM for various benign conditions showing no recurrence after 26 month follow-up.

Conclusion

The proposed modifications of MEMM provide a “double” window maxillary sinus control with access to all maxillary walls and preservation of the IT.

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Authors and Affiliations

  1. Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, University of Barcelona, c/ Villarroel 170, 08036, Barcelona, Catalonia, Spain

    Fernán Vicario-Quiñones, David Bedoya, Mauricio López-Chacón, Cristóbal Langdon, Manuel Bernal-Sprekelsen & Isam Alobid

  2. Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Ramón y Cajal, Madrid, Spain

    Alfonso Santamaría-Gadea

Authors
  1. Fernán Vicario-Quiñones
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  2. Alfonso Santamaría-Gadea
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  3. David Bedoya
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  4. Mauricio López-Chacón
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  5. Cristóbal Langdon
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  6. Manuel Bernal-Sprekelsen
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  7. Isam Alobid
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Corresponding author

Correspondence to Isam Alobid.

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Conflict of interest

M. Bernal-Sprekelsen: Advisory Board Lab. Salvat, Barcelona, Spain.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Vicario-Quiñones, F., Santamaría-Gadea, A., Bedoya, D. et al. Endoscopic maxillectomy: anatomo-radiological description of the “double” maxillary sinus window. Eur Arch Otorhinolaryngol 278, 3813–3820 (2021). https://doi.org/10.1007/s00405-021-06604-z

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  • DOI: https://doi.org/10.1007/s00405-021-06604-z

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