THE CASE FOR THE CALDWELL-LUC PROCEDURE

The increasing popularity of fiberoptic endonasal sinus surgery has led some to state that a Caldwell-Luc procedure should be performed only to manage tumors involving the maxillary sinus and epistaxis, a procedure that requires exposure of the pterygopalatine fossa for vessel ligation. However, a modern version of the Caldwell-Luc procedure should be considered in instances where failure of endoscopically-controlled endonasal sinus surgery (coupled with appropriate medical management) occurs because of the presence of severely or diffusely diseased or damaged mucosa. This approach is also suggested for suspected fungal sinusitis extensively involving the antrum, for all reoperations for isolated antral disease in which the ostiomeatal complex and ethmoids are clear, and for closure of oro-antral fistulas associated with marked inferior antral mucosal disease.