Abstract
Abstract The aim of the study was to assess the role of the intranasal prelacrimal recess approach (PLRA) in complete removal of anterior maxillary lesions. This was a prospective study in which 20 patients were recruited between July 2013 and September 2014 from the Otorhinolaryngology outpatient clinic, Cairo University. Patients with anterior maxillary sinus (MS) lesions underwent endoscopic sinus surgery and had their lesions removed through the maxillary ostium. The PLRA was then performed to assess the presence of any anterior maxillary remnants, which were then removed. The intranasal pathologies included sinonasal polyposis (four patients), recurrent sinonasal polyposis (four patients), antrochoanal polyps (four patients), allergic fungal sinusitis (five patients), inverted papilloma (one patient), lymphoma (one patient), and cancer maxilla (one patient). After the PLRA 45% of the patients showed remnants. These included antrochoanal polyp (two patients), recurrent sinonasal polyposis (one patient), allergic fungal sinusitis (three patients), inverted papilloma (one patient), lymphoma (one patient), and cancer maxilla (one patient). Our preliminary study demonstrated that without the PLRA 45% of the cases will have remnants missed in hidden areas of the MS. The PLRA is a minimally invasive technique to deal with anterior MS lesions.
Highlights
In spite of development of curved instrument, a reaching hidden area in the maxillary sinus (MS) is still problematic
The aim of the study was to assess the role of the intranasal prelacrimal recess approach (PLRA) in complete removal of anterior maxillary lesions
Patients with anterior maxillary sinus (MS) lesions underwent endoscopic sinus surgery and had their lesions removed through the maxillary ostium
Summary
The aim of the study was to assess the role of the intranasal prelacrimal recess approach (PLRA) in complete removal of anterior maxillary lesions. In spite of development of curved instrument, a reaching hidden area in the maxillary sinus (MS) is still problematic. Prelacrimal recess (PLR) is a concavity in the medial, anterosuperior part of the MS. It is located in front of the eminence of the lacrimal passages on the medial sinus wall (Fig. 1) (Hosemann W et al 2003). Good visualization is provided for complete excision of the lesion, from the viewpoint of minimal invasion, a drawback still exists in both external and intranasal surgical procedures. Compromise of the inferior turbinate (IT) and nasolacrimal duct (NLD) is often unavoidable (Brors D, et al 1999)
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