[Development of the facial and periodontal approach to the maxillary sinus]

The nasal approach for operations of the maxillary sinus is becoming increasingly popular. The oral approach provides the best access for demonstration of the orbital floor, for ligation of the maxillary artery, for drainage of resistant rhinogenic sinusitis, and for removal of foreign bodies, tooth roots, dislocated teeth, odontogenic cysts and benign tumours of the maxillary sinus. Formerly the anterior wall of the maxillary sinus was removed, but nowadays procedures preserving the bone are chosen. The classical otorhinolaryngological incision lies in the limbus of the vestibule. Maxillofacial surgeons prefer an incision at the junction of the attached to the unattached gingiva because scars in the limbus of the vestibule create problems during later fitting of a denture. A follow-up of 40 patients shows that the gingival marginal incision causes no problems. This incision, introduced by Peter in 1930, is therefore preferred. The marginal incision does not leave any visible scars. It corresponds to an incision on the alveolar ridge in the edentulous patient.