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 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.

OUTCOME OBJECTIVE 1: Understand the key surgical steps in completing a successful maxillary antrostomy

OUTCOME OBJECTIVE 2: Interpret clinical scenarios requiring more than a standard maxillary antrostomy

OUTCOME OBJECTIVE 3: Appreciate how to complete a mega-antrostomy and Denker’s approach to the maxillary sinus

BACKGROUND STATEMENT: Maxillary sinus pathology is often challenging given the sinus’s anatomy and physiology. This challenge is highlighted by common pathology such as inverted papillomas and chronic rhinosinusitis with mucin where access to the attachment site and removal of mucin, respectively, are critical.