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Role of Modified Endoscopic Medial Maxillectomy in persistent chronic maxillary sinusitis

Thulasidas P , Venkatraman V

Objective: Functional endoscopic sinus surgery (FESS) has a long-term high rate of success for symptomatic improvement in patients with medically refractory chronic rhinosinusitis. As the popularity of the technique continues to grow, however, so does the population of patients with postsurgical persistent sinus disease especially in those with a large window for ventilation and drainage. In addition chronic infections of the sinuses especially fungal sinusitis have a higher incidence of recurrence even though a wide maxillary ostium had been performed earlier. This subset of patients often represents a challenge to the otorhinolaryngologist. We have performed modified endoscopic medial maxillectomy (MEMM) for such patients’ with persistent maxillary sinus disease as a means of providing effective drainage and clearance of secretions.

Design: A retrospective review was done of all patients with persistent maxillary sinus disease who had undergone modified endoscopic medial maxillectomy between 2009 and 2012. We studied patient demographics, previous surgical history, follow up details and categorized the types of Endoscopic Medial Maxillectomies performed in different disease situations.

Subjects and interventions: We performed Modified endoscopic medial maxillectomies (MEMM) in 37 maxillary sinuses of 24 patients.

Results: The average age was 43.83 years. Average follow up was 14.58 months.All patients had good disease control in the post operative visits with no clinical evidences of recurrences.

Conclusion: Modified endoscopic medial maxillectomy appears to be an effective surgery for treatment of chronic, recalcitrant maxillary sinusitis.