구개골 수직판 제거술을 통한 상악동 자연공 확장술

Background and Objectives: Since the concept of functional sinus surgery and optical aids such as endoscopes and surgical microscopes have been introduced, more precise excision of pathologic lesions under a clear view has become popular in the treatment of chronic maxillary sinusitis. Although middle meatal antrostomy (MMA) is reported to be more effective than inferior meatal antrostomy, spontaneous closure rate of antrostomy opening is still high. This article aims to introduce our modified method of MMA capable of creating a considerably large antrostomy opening and to report our results for the patency of a surgically created maxillary sinus opening. Patients and Method: A total of 50 procedures were performed in 46 patients with severe maxillary sinusitis. We applied our modified antrostomy technique removing palatine bone for improved patency. Results: Our procedure proved very effective in maintaining the patency of the large antrostomy opening in 100% of cases. During the procedure, arterial bleeding, which was controlled without difficulty by electrocautery, was noted in four cases. Conclusion: Our modified MMA technique can be considered as an effective alternative surgical procedure for maintaining large MMA openings. (J Clinical Otolaryngol 2000;11:73–77)