Inferior Meatal Fenestration Operation of the Postoperative Maxillary Cysts

Suh, Kyung Shik; Lee, Jeung Gweon; Kim, Dong Young; Koh, Yoon Woo; Yang, Hae Dong; Kim, Bo Hyung

Abstract

BACKGROUND AND OBJECTIVES: Among the postoperative complications of Caldwell-Luc operation, maxillary cysts are sometimes difficult to manage properly by conventional revision Caldwell-Luc procedure. However, with the advent of endoscopic procedures, the technique of intranasal fenestration operation through the inferior meatus has been improved. This study evaluate the surgical results of inferior meatal fenestration operation and examines the clinical indication of this technique. The authors also review surgical cases of postoperative maxillary cyst. MATERIALS AND METHOD: We reviewed 58 cases of postoperative maxillary cyst which were treated surgically in the last 10 years. We analyzed their chief complaints such as sex, age, duration between the initial surgery and the presentation of the symptoms, symptom relief after revision surgery, and the recurrence rate of each surgical techniques. Sites of the cyst in the maxillary sinus and the existence of the septa were analysed radiologically by using computed tomograms of paranasal sinuses. Fourty-eight cases received inferior meatal fenestration operation and 12 cases received revision Caldwell-Luc operation.
RESULTS
Inferior meatal fenestration operation could be best indicated in the patients with bulging cysts in the inferior meatus. However, the non-bulging cysts which tare in contact with the inferior metus and those with the inferior metus and those with incomplete septa were also treated with the inferior meatal fenestration operation without recurrence. Comparing with the revision Caldwel-Luc procedure, the inferior meatal fenestration operation was less time consuming and provided less postoperative discomfort for the patients. Also, since the operation is carried out under the direct endoscopic control, fine procedures and the removal of septa in the cysts were possible.
CONCLUSIONS
For inferior meatal fenesration operation, the need for a pre-operative endoscopic nasal examination and an evaluation of comography should be emphasized before selecting the suitable method of treatment. Inferior meatal fenestration operations appear to be the most suitable treatment for cases where cysts bulge into the inferior meatus.