Jubilee Hospital, Trivandrm.
Open approaches to the maxillary sinus were first described in the early 1700s. The well-known Caldwell-Luc operation was first described in the United States by George Walter Caldwell in 1893 and then by Henri Luc of France in 1897. Subsequent advances in the understanding of the physiologic drainage pattern of the maxillary sinus led to intranasal middle meatal antrostomy in the late 1960s and the early 1970s.
Functional endoscopic sinus surgery (FESS) is based on the surgical approach performed by Messerklinger and Wigand in Europe via the osteomeatal complex. FESS has become the standard surgical treatment for chronic maxillary sinusitis, with external approaches being used as an adjunct in more complicated cases or in tumor management.
Caldwell Luc operation involves entering the sinus through the mouth by way of an incision into the canine fossa above a canine tooth,
Indications of Caldwel Luc operation:
and Removal of tooth roots within the sinus
and Removal of dental cysts within the sinus
and Closure of mouth-sinus communications (oro-antral
and Reduction of facial fractures especially those involving the orbital floor
and Treatment of chronic sinusitis
and Removal of antral polyps and cysts & antro-choanal polyp
and Removal of antral mucocÅ“les
and A route to the ethmoid and sphenoid sinuses
and Visualisation of the orbital floor for decompression
and Vidian (nerve of the Pterygoid Canal) neurectomy
and Various forms of tumor surgery and
and Access to the pterygo-maxillary fossa
The procedure is better carried out under General Anesthetic.
A small cut is made between the upper lip and gum and a bone window is made (giving access to the maxillary sinus) in the anterior wall of the maxillary sinus.
The natural opening of the sinus into the nasal cavity is often enlarged at the same time to improve drainage of normal secretions and reduce the chance of recurrent disease. Occasionally, a new opening (naso-antral window) is also created between the nose and maxillary sinus.
Pleasee the pictures below: