Caldwell-Luc Operation /
Intra-Oral Antrostomy
The Caldwell-Luc operation (in the Oral Surgical use of
the procedure) is used for the:
In the Ear, Nose & Throat 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).
The procedure can be carried out under Local
Anaesthetic though it may be a pleasanter experience all
round for it to be carried out under General Anaesthetic.

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.
These are the commoner risks. There may be other unusual risks that have not
specific concerns.

Common Complications:
  • Facial swelling
  • Pain ± numbness of the face (infra-orbital neurapraxia).  This is numbness of
    the cheek and not weakness, which always occurs temporarily but rarely
    persists and
  • Pain ± numbness (temporary / permanent) of the upper teeth (incisors
    around to the bicuspids) and the associated gums

Less Common Complications:

  • Failure of the cut to the gum above the upper teeth to heal, which can result
    in a mouth-sinus communication (oro-antral communication / fistula) (< 1%).  
    This may close spontaneously with time or may require further surgery.
  • Post-operative nosebleeds (epistaxis)
  • Overflow of tears (epiphora) due to blockage of the tear duct and
  • Tooth root injury leading to tooth death (devitalisation) & tooth discoloration

Rare Complications:

  • Facial asymmetry due to persistent facial swelling attributed to scarring and
    thickening of the facial tissues (possibly due to escaped lymphatic fluid from
    the damaged lymphatic channels following excessive retraction of the cheek).
  • Prolonged maxillary sinusitis.
  • Post-op bleeding from the sinus / nose requiring packing of the sinus / nose
    or even a blood transfusion.
  • Infection of the naso-lacrimal sac (dacryocystitis) (2ndary to naso-lacrimal
    duct obstruction).
  • Post-op hypersensitivity or 'burning’ pain over the cheek, gums or teeth'
    (hypæsthesia / dysæsthesia of the Infra-Orbital Nerve).
  • Blindness (if the eye socket is entered) & reduced sharpness of vision &
    movement of the eye (ocular dysfunction).


Website & Article:

Australian & New Zealand Journal of Surgery 2008.  Complications Of The
Caldwell-Luc Operation And How To Avoid Them.

New York Eye & Ear Infirmary - ENT Academic Faculty
 
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