Caldwell-Luc surgery

Surgical procedure for maxillary sinus access

Caldwell-Luc surgery is a surgical procedure used to access the maxillary sinus for the purpose of drainage or removal of pathological tissue. It is named after the American surgeon George Walter Caldwell and the French laryngologist Henri Luc, who independently described the technique in the late 19th and early 20th centuries.

History

The Caldwell-Luc procedure was first described by George Caldwell in 1893 and later by Henri Luc in 1897. It was developed as a method to treat chronic maxillary sinusitis and other sinus-related conditions that were not responsive to medical therapy. The procedure became a standard approach for accessing the maxillary sinus before the advent of modern endoscopic techniques.

Indications

Caldwell-Luc surgery is indicated in cases where there is a need for direct access to the maxillary sinus. Common indications include:

• Chronic maxillary sinusitis unresponsive to medical treatment
• Removal of maxillary sinus tumors
• Treatment of maxillary sinus cysts
• Management of oroantral fistula
• Biopsy of suspicious lesions within the sinus

Procedure

The procedure is typically performed under general anesthesia. The surgeon makes an incision in the gingivobuccal sulcus, which is the groove between the upper lip and the gum. This provides access to the anterior wall of the maxillary sinus. A small window is created in the bone to allow entry into the sinus cavity.

A Kerrison punch, a tool used in Caldwell-Luc surgery

Once inside the sinus, the surgeon can remove diseased tissue, drain fluid, or perform other necessary interventions. The sinus is then irrigated, and the incision is closed with sutures.

Complications

As with any surgical procedure, Caldwell-Luc surgery carries potential risks and complications, including:

• Bleeding
• Infection
• Damage to surrounding structures, such as the infraorbital nerve
• Formation of an oroantral fistula
• Facial swelling and bruising

Advantages and Disadvantages

The Caldwell-Luc procedure provides direct access to the maxillary sinus, allowing for thorough examination and treatment. However, it is more invasive than endoscopic sinus surgery and may result in more postoperative discomfort and a longer recovery period.

Current Use

With the advent of endoscopic sinus surgery, the use of Caldwell-Luc surgery has declined. Endoscopic techniques offer a less invasive approach with reduced morbidity. However, Caldwell-Luc surgery remains a valuable option in certain cases where endoscopic access is not feasible or when dealing with specific pathologies that require open access.

Related pages

• Maxillary sinusitis
• Endoscopic sinus surgery
• Oroantral fistula