[Therapeutic limits of endonasal fenestration of the maxillary sinus]

The endoscopical examination of the diseased maxillary sinus is a common procedure. In cases with obstruction of the ostium the intranasal antrostomy is carried out. 117 operations were followed up 1-7 years postoperatively. In 25.6% of the cases the windows into the inferior meatus were closed. The operation did not yield any improvement of the clinical features in 37% of the cases. There was no correlation to a open or closed window. In these patients the endoscopical and radiological examinations now revealed a diseased ethmoid. Instead of intranasal antrostomy, endoscopical endonasal surgery of the anterior ethmoid (technique of Messerklinger) is recommended. With this procedure, reestablishment of free ventilation of the maxillary sinus is combined with the diagnosis and the therapy of the diseased anterior ethmoid.