Usefulness of partial uncinectomy in patients with localized maxillary sinus pathology

Abstract

Purpose: Conventional total uncinectomy may be unnecessary in localized maxillary sinus lesion. Partial removal of the uncinate process and middle meatal antrostomy would be sufficient to eradicate the pathological condition. Therefore, we aimed to evaluate the efficacy of partial uncinectomy versus total removal of the uncinate process in patients with localized maxillary sinus disease. Methods: In total, 25 patients were assigned randomly to partial and total uncinectomy groups. Preoperative computed tomography established that all patients had localized pathology in the maxillary sinus. The lower half of the uncinate process was removed in the partial uncinectomy group, while the total uncinectomy group underwent the conventional surgery. Time required for the uncinectomy, healing period for the uncinectomy site, incidence of lamina papyracea or nasolacrimal duct injury, obstruction or stenosis of the frontal recess, and incidence of synechia formation in the middle meatus were compared between the groups. Results: All patients completed the follow-up and were included in the analysis. Surgical indications included chronic maxillary sinusitis, fungal sinusitis, antrochoanal polyp, and odontogenic sinusitis. Operation durations and healing periods were significantly shorter in the partial uncinectomy group. One patient had a minor injury to the lamina papyracea and two patients showed partial synechia formations in the total uncinectomy group. However, other parameters did not differ significantly between the groups. Conclusions: Partial uncinectomy may be useful in patients with pathological conditions confined to the maxillary sinus. Shorter operation duration, more rapid healing, and lower incidence of complications are advantages over a conventional total uncinectomy. (C) 2014 Elsevier Inc. All rights reserved.