SCOPING REVIEW OF SURGICAL APPROACHES IN ENDOSCOPIC MAXILLARY SINUS SURGERY FROM 2015 TO 2024
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Abstract
Abstract
Objective: To synthesize and describe the outcomes of various surgical approaches in endoscopic maxillary sinus surgery. Methods: A scoping review was conducted by searching PubMed and Google Scholar databases to identify English-language articles on endoscopic maxillary sinus surgery published between January 2015 and December 2024. Eligible studies included those reporting surgical techniques and postoperative outcomes. Results: Sixteen studies met the inclusion criteria, addressing maxillary sinus conditions such as chronic inflammation, cysts, antrochoanal (Killian) polyps, and benign or malignant tumors. Inverted papillomas (IPs) were the most frequently investigated entity (62.5%). Six surgical approaches were identified: middle meatal antrostomy, inferior meatal antrostomy, mega-antrostomy, medial maxillectomy, prelacrimal recess approach (PLRA), and endoscopic Denker's approach. The modified endoscopic medial maxillectomy (MEMM) and the PLRA were the most commonly employed (each accounting for 37.5%). The recurrence rate over 1-180 months of follow-up ranged from 0% to 18.5%. The highest recurrence rates were observed in malignancies (18.5%) and cysts (15.9%), while IPs showed a range of 0% to 7.04%. The main complications reported were facial numbness (3.4%-27.2%) and nasolacrimal duct injury (5.9%-18.1%). Conclusions: Endoscopic maxillary sinus surgery is a safe and effective treatment modality. The choice of surgical approach should be tailored to the patient’s sinonasal anatomy and the nature of the lesion to optimize outcomes and minimize complications.
Key words: complications; endoscopic maxillary sinus surgery; surgical approaches
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References
2. Costa F, Emanuelli E, Franz L, Tel A, Sembronio S, Robiony M. Fungus ball of the maxillary sinus: Retrospective study of 48 patients and review of the literature. Am J Otolaryngol. 2019;40(5):700-704. doi:10.1016/j.amjoto.2019.06.006
3. Thompson LDR, Franchi A. New tumor entities in the 4th edition of the World Health Organization classification of head and neck tumors: Nasal cavity, paranasal sinuses and skull base. Virchows Arch Int J Pathol. 2018;472(3):315-330. doi:10.1007/s00428-017-2116-0
4. Kane KJ. The early history and development of functional endoscopic sinus surgery. J Laryngol Otol. 2020;134(1):8-13. doi:10.1017/S0022215119002457
5. Ghosh A, Pal S, Srivastava A, Saha S. Modification of endoscopic medial maxillectomy: a novel approach for inverted papilloma of the maxillary sinus. J Laryngol Otol. 2015;129(2):159-163. doi:10.1017/S0022215114003144
6. Erbek SS, Koycu A, Buyuklu F. Endoscopic modified medial maxillectomy for treatment of inverted papilloma originating from the maxillary sinus. J Craniofac Surg. 2015;26(3):e244-246. doi:10.1097/SCS.0000000000001589
7. Comoglu S, Celik M, Enver N, Sen C, Polat B, Deger K. Transnasal Prelacrimal Recess Approach for Recurrent Antrachoanal Polyp. J Craniofac Surg. 2016;27(4):1025-1027. doi:10.1097/SCS.0000000000002699
8. Turri-Zanoni M, Battaglia P, Karligkiotis A, et al. Transnasal endoscopic partial maxillectomy: Operative nuances and proposal for a comprehensive classification system based on 1378 cases. Head Neck. 2017;39(4):754-766. doi:10.1002/hed.24676
9. Pagella F, Pusateri A, Matti E, et al. “TuNa-saving” endoscopic medial maxillectomy: a surgical technique for maxillary inverted papilloma. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg. 2017;274(7):2785-2791. doi:10.1007/s00405-017-4549-0
10. Suzuki M, Nakamura Y, Yokota M, Ozaki S, Murakami S. Modified transnasal endoscopic medial maxillectomy through prelacrimal duct approach. The Laryngoscope. 2017;127(10):2205-2209. doi:10.1002/lary.26529
11. Lin YT, Lin CF, Yeh TH. Application of the endoscopic prelacrimal recess approach to the maxillary sinus in unilateral maxillary diseases. Int Forum Allergy Rhinol. 2018;8(4):530-536. doi:10.1002/alr.22062
12. Wang F, Yang Y, Wang S, Chen H, Wang D, Wang Q. Management of maxillary sinus inverted papilloma via endoscopic partial medial maxillectomy with an inferior turbinate reversing approach. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg. 2017;274(12):4155-4159. doi:10.1007/s00405-017-4749-7
13. Zhou B, Huang Q, Sun J, et al. Resection of Inverted Papilloma of the Maxillary Sinus via a Prelacrimal Recess Approach: A Multicenter Retrospective Analysis of Surgical Efficacy. Am J Rhinol Allergy. 2018;32(6):518-525. doi:10.1177/1945892418801243
14. Landsberg R, Warman M, Margulis A, Masalha M. The Rationale for Endoscopic Inferior Meatal Antrostomy. ORL J Oto-Rhino-Laryngol Its Relat Spec. 2019;81(1):41-47. doi:10.1159/000496087
15. Arosio AD, Valentini M, Canevari FR, et al. Endoscopic Endonasal Prelacrimal Approach: Radiological Considerations, Morbidity, and Outcomes. The Laryngoscope. 2021;131(8):1715-1721. doi:10.1002/lary.29330
16. Stavrakas M, Karkos PD, Tsinaslanidou Z, Constantinidis J. Endoscopic Denker’s Approach for the Treatment of Extensive Sinonasal Tumors: Our Experience. The Laryngoscope. 2021;131(7):1458-1462. doi:10.1002/lary.29235
17. Tran LV, Psaltis A, Le LT, Siow JK. A prelacrimal approach technique to overcome the limitation of the narrow lacrimal recess. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg. 2021;278(6):1885-1889. doi:10.1007/s00405-020-06472-z
18. Huang AE, Low CM, Stokken JK. Extended Anterior Inferior Approach to Endoscopic Medial Maxillectomy for Maxillary Sinus Lesions. Am J Rhinol Allergy. 2021;35(6):895-901. doi:10.1177/19458924211025371
19. Lou Z. Surgical outcomes between two endoscopic approaches for maxillary cysts. Braz J Otorhinolaryngol. 2022;88 Suppl 5(Suppl 5): S112-S118. doi:10.1016/j.bjorl.2022.05.006
20. Preda MA, Musat G, Sarafoleanu C. Surgical Endoscopic Treatment of Odontogenic Sinusitis. Chir Buchar Rom 1990. 2024;119(1):76-86. doi:10.21614/chirurgia.2024.v.119.i.1.p.76
21. Gutiérrez-Posso, J. D., Zabala-López-de-Maturana, A., Arango-Molina, A. M., Santaolalla-Montoya, F., & Santaolalla-Sánchez, F. J. (2025). Cost-effectiveness analysis of endoscopic sinus surgery versus external approach for sinonasal inverted papilloma. Journal of comparative effectiveness research, e250109. Advance online publication. https://doi.org/10.57264/cer-2025-0109
22. Li, X., Wang, D., & Yin, D. (2025). Clinical characteristics and recurrence predictors of sinonasal inverted papilloma: a retrospective cohort study. Frontiers in oncology, 15, 1537905. https://doi.org/10.3389/fonc.2025.1537905
23. Ashman, A., Psaltis, A. J., Wormald, P. J., & Tan, N. C. (2020). Extended endoscopic approaches to the maxillary sinus. The Journal of laryngology and otology, 134(6), 473–480. https://doi.org/10.1017/S0022215120000882
24. London, S. D., Schlosser, R. J., & Gross, C. W. (2002). Endoscopic management of benign sinonasal tumors: a decade of experience. American journal of rhinology, 16(4), 221–227.
25. Machado, A., Pereira, J., Alvarez, F., Briner, H. R., & Simmen, D. (2024). Prelacrimal window approach to the maxillary sinus: a systematic review and meta-analysis of the literature. Rhinology, 62(3), 271–286. https://doi.org/10.4193/Rhin23.296