Inferior Turbinate Swing Approach for Inaccessible Maxillary Sinus Lesions

Abstract

Background and Objectives Maxillary sinus is easily accessible through endoscopic surgery; however, additional combined approaches may be required depending on primary lesions. These approaches are canine fossa approach (CFA), Caldwell-Luc operation (C-L op), Denker approach, and inferior turbinate (IT) swing technique. Our purpose was to analyze and compare the overall results of these surgical approaches to determine superiority.Subjects and Method Records of patients who underwent surgery of functional endoscopic sinus surgery (FESS) with CFA, C-L op, Denker approaches or IT swing technique in a single tertiary hospital from 2015 to 2023 were studied retrospectively. Patients who underwent additional surgery other than CFA, C-L op, Denker, and IT swing technique were excluded.Results A total 86 patients underwent FESS with combined approaches. IT swing technique was used for 30 patients, Denker op was performed for three patients, and C-L op or CFA was used for 53 patients. IT swing technique, Denker op, and C-L op were mainly used for nasal cavity tumor, such as inverted papilloma (IP). CFA was used for not only CRS w NP but also for IP. Recurrence was reported for the IT swing group and CFA group in IP. Three out 20 patients relapsed in the IT swing group, and two out of six patients relapsed in the CFA group.Conclusion The IT swing technique is a good minimally invasive surgical method that can secure the anteromedial field of view of maxillary sinus, but complete drilling of the remnant bone is required for IP.