Endoscopic sinus surgery for the anterior maxillary sinus, using a 135° reflective CO2 laser

OBJECTIVES: Endoscopic sinus surgery has been widely performed to treat nose and paranasal diseases. However, it is difficult to manipulate anterior wall lesions of the maxillary sinus using conventional surgical instruments. This paper presents a method of performing endoscopic surgery for anterior wall lesions of the maxillary sinus, using a 135 degrees reflective CO2 laser. METHOD: A CO2 laser with a 135 degrees reflective tip on the pipe-guide handpiece and a CO2 laser angulated to the same degree were used. The pipe-guide handpiece with reflective tip was inserted into the nasal cavity and the base of the maxillary sinus anterior wall lesion was vaporised and removed via an enlarged natural ostium. During the procedure, the maxillary antrum was visualised with a 70 degrees endoscope. Ten cases of maxillary sinus anterior wall lesion underwent this surgical procedure. RESULTS: In all cases, the base of the maxillary sinus anterior wall lesion was removed completely and recurrence avoided. CONCLUSION: This method is a reliable procedure enabling endoscopic sinus surgery for anterior wall lesions of the maxillary sinus.