Aim. The objective of the present study was to develop the technique of the minimally invasive, organ-preserving intranasal access to the maxillary sinus for the enhancement of the effectiveness of the surgical treatment of the patients presenting with chronic cystic maxillary sinusitis. Materials and methods. A total of 138 patients with this pathology were available for the examination including 102 whose conditions were evaluated by means of computed tomography of the paranasal sinus. Syntopy of the conchal crest (crista conchalis) of the maxillary bone with respect to the distal end of the nasolacrimal canal and the lumen of the maxillary sinus was evaluated. Results and discussion. The study has demonstrated that the nasolacrimal canal was located under the inferior nasal turbinated bone (with respect to the nasal cavity floor) and opened at a depth of 13.93 ± 0.02 mm from the edge of the bone aperture of the nose and at a height of 11.86 ± 0.03 mm The distal part of the nasolacrimal canal lay 3.49 ± 0.02 mm above the crista conchalis level of the maxillary bone, at a depth of 19.77 ± 0.17 mm from edge of the bone aperture of the nose in the subjects younger than 20 years, and at a depth of 22.04 ± 0.09 mm in those of older age groups. The data obtained provided the basis for the development of the original safe method for endonasal opening of the maxillary sinus in the vicinity of crista conchalis without an injury to the nasolacrimal canal at the level of the anterior end of the inferior nasal turbinated bone. The vertical incision of the mucous membrane 0.5 – 1.0 cm in the length is made 1 mm from the edge of the bone aperture of the nose; thereafter, the conchal crest is exposed up to the to the place of its attachment to the inferior nasal turbinated bone. Then, the diamond drill is used to carry out trepanation of the medial wall of the maxillary sinus in the vicinity of crista conchalis of the maxillary bone. This procedure is followed by sanitation of the cavity at the edge of the incision, its two edges are then approximated and fixed by two sutures. This technique was applied for the surgical treatment of 36 patients with chronic cystic maxillary sinusitis. Conclusion. The original method for endonasal maxillary sinusotomy in the vicinity of crista conchalis of the maxillary bone proposed in the present study provides a highly efficient tool for the removal of the retention cysts of the maxillary sinus. The safety of the surgical access to the maxillary sinus through the conchal crest of the maxillary bone has been confirmed by the results of the CT examination of the paranasal sinus that has demonstrated that the upper edge of the antrostoma is located 4.46 ± 0.08 mm below the level of the distal end of the inferior nasal turbinated bone. The data presented in this article on the syntopy of the distal end of the nasolacrimal canal can be used as anatomical landmarks during endonasal surgical interventions, such as radical operations on the maxillary sinus and antrostomy in the vicinity of the lower nasal passage. The original access through the conchal crest of the maxillary bone can be recommended for the routine application in the otorhinolaryngological practice as a method for the surgical treatment of chronic cystic maxillary sinusitis.