| Surgical-Dentistry.Info |
| Caldwell-Luc Operation / Intra-Oral Antrostomy |
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- Removal of tooth roots within the sinus
- Removal of dental cysts within the sinus
- Closure of mouth-sinus communications (oro-antral
fistulæ) - Reduction of facial fractures especially those
involving the orbital floor
In the ENT sense, the Caldwell-Luc procedure is used for:
- Treatment of chronic sinusitis
- Removal of antral polyps and cysts & antro-choanal
polyps - Removal of antral mucocœles
- A route to the ethmoid and sphenoid sinuses
- Visualisation of the orbital floor for decompression
- Vidian (nerve of the Pterygoid Canal) neurectomy
- Various forms of tumour surgery and
- Access to the pterygo-maxillary fossa (the space
behind the maxillary sinus).
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.
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.
These are the commoner risks. There may be other
unusual risks that have not been listed here. Please ask
your Oral Surgeon if you have any general or specific
concerns.
Common Complications:
Less Common Complications:
Rare Complications:
unusual risks that have not been listed here. Please ask
your Oral Surgeon if you have any general or specific
concerns.
Common Complications:
- facial swelling (61.9%)
- pain ± numbness of the face (46.0%) (infra-orbital
neurapraxia (numbness of the cheek, not weakness)
which always occurs temporarily but rarely persists
and - pain ± numbness (temporary or permanent) of the
teeth/gums (30.9%).
Less Common Complications:
- failure of the incision above the upper teeth to heal,
which can result in a mouth-sinus communication
(oro-antral communication / fistula) (< 1%). This
may close spontaneously in time or may require
further surgery. - post-operative epistaxis (nosebleeds) (0.4%)
- epiphora (0.4%) and
- tooth root injury leading to devitalisation & tooth
discoloration (< 1%).
Rare Complications:
- Facial asymmetry due to persistent facial swelling
attributed to pre-maxillary fibrosis and thickening (?
due to extravastaion of lymph from the damaged
lymphatic channels following excessive retraction –
avoided by using modified or long sub-labial incision) - Chronic maxillary neuralgia ?dysæsthesia meant
- Persistent maxillary sinus disease
- Post-operative bleeding requiring replacement of
packing or even a blood transfusion - Infection
- Gingivo-labial fistula
- Dacryocystitis
- Cheek discomfort
- Post-op hypæsthesia (< 17.5% of patients)
- Post-op ethmoiditis
- Blindness (when orbit is entered)
- Ocular dysfunction – reduced sharpness of vision &
mobility of eye - Delayed mucocœle
- Nasal synechiæ
- Naso-antral communications
- Recurrence of sinus disease / sinusitis
- Recurrent antral polyps