[A proposal for endonasal middle meatal antrostomy].

With increase of cases with mild chronic sinusitis, especially the cases combined with nasal allergy, endonasal sinus surgery has been substituted for Caldwell-Luc or some other modified sinus surgery in recent years. The classical inferior meatal antrostomy for maxillary sinusitis is one of the treatments of choice, though this opening is easily closed and is somewhat different from normal sinus physiology. In the middle meatal antrostomy, the opening was made via the inferior turbinate or the middle meatal wall perforated with nasal forceps. Reported here is a new technique for middle meatal antrostomy which can be easily and safely performed. At the beginning, mucosal incision is made from the agger nasi to the anterior of the inferior turbinate, dividing the mucous membrane inferomedially. Then the mucous membrane of the inferior turbinate is cut along the upper margin of it and reflected downwards. With this procedure, the frontal process of the maxilla, lacrimal bone and inferior turbinate are well exposed and well oriented in the surgical field. The pars membranacea is then cut from anterior to inferior, and removed with the uncinate process, thus entering the maxillary antrum. The antrostomy opening is made at least 1 by 1.5 cm wide. Then, the intranasal ethmoidectomy is usually done and the reflected mucous membrane of the inferior turbinate returned to its normal position. This surgery was applied to 34 patients (7 children, 27 adults), (2 antrochoanal polyps, 5 optic neuritis, 3 maxillary sinusitis, 17 pansinusitis, and 7 pansinusitis associated with nasal allergy). We have not experienced surgical complications and none of them also had closure of the antrostomy opening.(ABSTRACT TRUNCATED AT 250 WORDS)