Surgical Approaches to Tackling Pathology Anywhere in the Maxillary Sinus

PROGRAM DESCRIPTION: The anatomy and physiology of the maxillary sinus makes it one of the most challenging sinuses to approach endoscopically. Despite its complexity, management of maxillary sinus pathology is often taken for granted. However, key steps to the standard maxillary antrostomy and use of more advanced approaches to address diseases along the floor, anterior and lateral walls of the maxillary sinuses are critical in minimizing recurrences.

In this expert lecture, we will highlight critical steps in completing an endoscopic maxillary antrostomy including appreciation of pre-operative imaging for variations in maxillary sinus anatomy, use of angled instrumentations, and appropriate management of the uncinate and middle turbinate. We will discuss silent sinus syndrome and surgical implications and outcomes when performing a maxillary antrostomy related to this diagnosis. Maxillary antrostomies are often performed for chronic rhinosinusitis. Eosinophilic mucin can be associated with more severe forms of CRS and critical to clear to minimize risk of recurrent disease. We will discuss techniques to remove and visualize mucin in these hard to access areas of the maxillary sinus. We will then discuss challenging locations to address and highlight advantages of a mega-antrostomy and Denker’s approach. In addition to reviewing the surgical approach, we will review key angled instrumentations to utilize when approaching the maxillary sinus.