Surgery of the maxillary sinus has focused in recent times on interventions centered around the natural ostium of the sinus. Controversies abound regarding the ideal instrumentation for such surgery, indications for particular techniques and the benefit of uncienectomy alone versus a large or small antrostomy. While no absolute answer exists for these questions, this article will examine arguments in favor of and against a variety of surgical interventions. Special considerations apply in treatment of the severely diseased sinus, in the “Silent Sinus Syndrome” and in orbital decompression of thyroid eye disease.
The concept of more extensive surgery for selected cases of failure of maxillary ostioplasty is gaining increasing prominence. These operations are performed with goals in mind other than restoration of muco-ciliary clearance.
Cotemporary maxillary sinus surgery required a careful examination of patient symptoms with individualization of surgical procedures to specific patient priorities.