Cysts of the maxillary sinus account for about 20% of all causes of surgical interventions in the maxillary sinus. Taking into account the pathophysiology of cysts, the most appropriate surgical approach is the inferior meatus antrostomy. A possible solution to minimize the size of the antrostomy in the inferior meatus but not to diminish degree of visual control is the use of a two-way approach.

OBJECTIVE

To improve the results of endonasal endoscopic surgery of maxillary cysts by using a two-way approach.

PATIENTS AND METHODS

The study involved 100 patients with maxillary sinus retention cysts, who were undergoing surgical treatment in the otorhinolaryngology clinic «KORL» (Kazan) from 2015 to 2018. All patients underwent surgical removal of cysts by the approach in the inferior meatus using a shaver. Depending on the applied modification of the approach, the patients were divided into 3 groups: 1st — with a permanent antrostomy; 2nd — with a temporary antrostomy; 3rd — a two-way approach. The effectiveness of the two-way approach was evaluated according to three criteria: the degree of visual control during cyst removal, recurrence of cyst for six months after surgery, and the state of the medial wall of the maxillary sinus (according to computer tomography data and endoscopic examination).

RESULTS AND CONCLUSION

Patients, who underwent surgery by using the two-way approach, showed the best results: the antrostomy in the inferior meatus, due to its small size, did not violate the physiology of the maxillary sinus; removal of the cyst under full visual control reduced the risk of recurrence in the postoperative period.