Extended endoscopic approaches to non-malignant maxillary sinus lesions

Abstract Background A variety of surgical methods were described to access lesions in the maxillary sinus (MS). Endoscopic maxillary mega-antrostomy is typically used when indicated to provide proper visualization of nearly all walls of sinus cavity with complete resection of the pathology. This work aimed to compare the results of endoscopic middle meatus mega-antrostomy, endoscopic pre-lacrimal recess approach, and endoscopic modified medial maxillectomy. Methods This descriptive study included 100 patients with MS pathology who were candidates for endoscopic sinus surgery in the Otorhinolaryngology Department Tanta University hospital. Patients after endoscopic sinus surgery were allocated into three groups: Group (A) (n = 36): underwent middle meatal mega-antrostomy approach to MS, group (B) (n = 29): underwent endoscopic modified medial maxillectomy approach to MS, group (C) (n = 35): underwent endoscopic prelacrimal recess approach to MS. Results As regards total SNOTT 22 scores for all items, there was statistically difference between all groups as regards to pre and postoperative results (p value was < .001). Results of group A was statistically better than group B&C as regards to pre & postoperative scores. As regards to rhinological domain and health and quality of life domain, there was statistically difference between all groups as regards to postoperative results only (p value was < .001). Conclusions The middle meatal mega-antrostomy approach to MS gives significantly faster healing than other groups. The modified medial maxillectomy approach to MS had a better SNOT-22.