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Posterior translacrimal approach to the maxillary sinus

  • D Dönmez (a1), E Giotakis (a1), W G Hosemann (a2), T S Kühnel (a3), B Hirt (a4) and R K Weber (a1) (a5)...

This study aimed to compare the view into the maxillary sinus using the posterior translacrimal approach compared with grade 3 antrostomy.


Grade 3 antrostomy followed by a posterior translacrimal approach was performed on four cadavers. The maximum intramaxillary view was documented endoscopically guided by electromagnetic navigation. Representative screenshots were evaluated in a blinded manner by three independent sinus surgeons. In addition, a prospective investigation of specific complications in the post-operative course of consecutive patients was performed.


In the cadaver study, the posterior translacrimal approach provided a significantly better view into the maxillary sinus compared with grade 3 antrostomy. In the clinical study, only 1 out of 20 patients reported on a minor problem with lacrimal drainage at 6 months.


The posterior translacrimal approach to visualising the maxillary sinus should be considered a strong alternative to more radical techniques.

Corresponding author
Address for correspondence: Dr D Dönmez, Department of Otorhinolaryngology, Municipal Hospital of Karlsruhe, Moltkestraße 90 D- 76133 Karlsruhe, Germany Fax: +49 721 974 2509 E-mail:
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1 Kennedy, DW, Adappa, ND. Endoscopic maxillary antrostomy: not just a simple procedure. Laryngoscope 2011;121:2142–5
2 Weber, RK, Hosemann, W. Comprehensive review on endonasal endoscopic sinus surgery. GMS Curr Top Otorhinolaryngol Head Neck Surg 2015;14:1108
3 Stammberger, H. Comments on the contribution by U. Goede. Maxillary sinus fenestration via the middle vs. lower nasal passage [in German]. HNO 1998;46:95101
4 Konstantinidis, I, Constantinidis, J. Medial maxillectomy in recalcitrant sinusitis: when, why and how? Curr Opin Otolaryngol Head Neck Surg 2014;22:6874
5 Simmen, D, Jones, NS. Manual of endoscopic sinus and skull base surgery, 2nd edn. Stuttgart, New York: Thieme, 2013;8:91106
6 Wormald, PJ. Endoscopic sinus surgery, 3rd edn. Stuttgart, New York: Thieme, 2013;5:2844
7 Albu, S, Tomescu, E. Small and large middle meatus antrostomies in the treatment of chronic maxillary sinusitis. Otolaryngol Head Neck Surg 2004;131:542–7
8 Ngoc Ha, T, Valentine, R, Moratti, S, Robinson, S, Hanton, L, Wormald, PJ. A blinded randomized controlled trial evaluating the efficacy of chitosan gel on ostial stenosis following endoscopic sinus surgery. Int Forum Allergy Rhinol 2013;3:573–80
9 Hosemann, W, Scotti, O, Bentzien, S. Evaluation of telescopes and forceps for endoscopic transnasal surgery on the maxillary sinus. Am J Rhinol 2003;17:311–16
10 Robey, A, O'Brien, EK, Leopold, DA. Assessing current technical limitations in the small-hole endoscopic approach to the maxillary sinus. Am J Rhinol Allergy 2010;24:396401
11 Albu, S, Gocea, A, Necula, S. Simultaneous inferior and middle meatus antrostomies in the treatment of the severely diseased maxillary sinus. Am J Rhinol Allergy 2011;25:e80e85
12 Zhou, B, Han, DM, Cui, SJ, Huang, Q, Wei, YX, Liu, HC et al. Endoscopic nasal lateral wall dissection approach to maxillary sinus [in Chinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2007;42:743–8
13 Sathananthar, S, Nagaonkar, S, Paleri, V, Le, T, Robinson, S, Wormald, PJ. Canine fossa puncture and clearance of the maxillary sinus for the severely diseased maxillary sinus. Laryngoscope 2005;115:1026–9
14 Giotakis, EI, Weber, RK. Cysts of the maxillary sinus: a literature review. Int Forum Allergy Rhinol 2013;3:766–71
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
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