[The Caldwell-Luc procedure in the management of maxillary sinusitis. Long-term results].

BACKGROUND

The surgical technique proposed by Caldwell and Luc more than a century ago has been applied in over a million cases to treat maxillary sinusitis. A critical re-evaluation of the method has been in progress for several years, in the light of the results that can be achieved with endoscopic functional surgery.

METHODS

In a retrospective study, operations performed according to the Caldwell-Luc technique on 40 patients, mean age 45 years, between 1992 and 1996, were evaluated critically to determine the efficacy of this approach in treating maxillary sinusitis, with particular emphasis on the incidence of immediate or delayed complications. Initially, clinical and radiological data concerning each patient where considered with particular reference to the subjective and objective symptomatology, preoperative radiological diagnosis and etiology of the sinusitis.

RESULTS

Having completed the analysis of the documentation available, some of the patients were recalled and subjected to an in-depth instrumental diagnosis through traditional and CT radiography.

CONCLUSIONS

It was concluded that, in consideration of the marked incidence of complications, the Caldwell-Luc procedure may be defined as a non-obligatory therapeutic option even in chronic maxillary sinusitis. The use of this surgical procedure is rational in cases of antral tumour, trauma, very serious mycotic or septic factors, or when a surgical approach to the pterigo-maxillary fossa is necessary. In all other cases, the preferred treatment must now be endoscopy.