[Surgical treatment of chronic maxillary sinusitis. Report of a new surgical technic and an evaluation of results of traditional surgery].

During recent years, a new operative procedure for treatment of chronic maxillary sinusitis has been strongly recommended as being more effective and more physiological than the traditional Caldwell-Luc operation. The principle of the method is endoscopically guided endonasal resection of the anterior ethmoid cells and enlargement of the natural ostium of the maxillary sinus in the middle meatus. In contrast, the principle in the Caldwell-Luc operation is opening into the sinus in the canine fossa, providing direct approach to the lumen, and finally creation of a fenester towards the inferior meatus. However, the publications hitherto presented have not documented clearly the efficiency of this new method, which also appears to have an increased risk of complications, some of which are serious. The present study elucidates the efficiency and side effects of the traditional Caldwell-Luc operation in 77 patients (107 maxillary sinuses). Four to nine years after the operation 73% of the patients had had satisfactory subjective effect of the operation. Consistency was present between the subjective estimation and the objective findings at follow-up. The effects included only slight disturbances of the sensibility in the infraorbital nerve (n = 9) or teeth (n = 6). However, only two patients (3%) had more troublesome change of the sensibility in the infraorbital nerve and in one patient only a subjectively "dead" tooth was also avital at vitality testing. The survival of the teeth was estimated roughly by comparison of the number of teeth on the operated side versus the non-operated side and was unimpaired.(ABSTRACT TRUNCATED AT 250 WORDS)