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Endoscopic medial maxillectomy with preservation of inferior turbinate and nasolacrimal duct

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Endoscopic medial maxillectomy (EMM) is a safe and effective procedure for treatment of inverted papilloma (IP) originating from the maxillary sinus. However, EMM usually removes the inferior turbinate and nasolacrimal duct. The inferior turbinate has a critical function in conditioning of the nasal airflow, and resection of the nasolacrimal ducts has a risk of epiphora. We developed a newly derived surgical technique, endoscopic modified medial maxillectomy (EMMM), which enables preservation of the inferior turbinate and nasolacrimal duct.


A retrospective case series of six patients with IP and nine patients with mucoceles of the maxillary sinus after a Caldwell-Luc operation, who underwent surgery using the EMMM technique, were reviewed.


In patients with IP, there were no recurrences for a mean follow-up of 16.7 months. Eight of nine patients with mucoceles of the maxillary sinus showed patency. All patients showed preservation of the inferior turbinate. One patient with mucocele was referred for dacryocystorhinostomy because of epiphora.


EMMM produces access to the maxillary sinus identically to conventional EMM, despite preservation of the inferior turbinate and nasolacrimal duct.

Keywords: Endoscopic medial maxillectomy; endoscopic modified medial maxillectomy; epiphora; inferior turbinate; inverted papilloma; maxillary sinus; mucocele; nasolacrimal duct

Document Type: Research Article


Affiliations: Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan

Publication date: September 1, 2012

More about this publication?
  • The American Journal of Rhinology & Allergy, is a peer reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    Previously published as American Journal of Rhinology, the journal is indexed in Thomson Reuters Web of Science and Science Citation Index, plus the National Library of Medicine's PubMed service.
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