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The Maxillary Lid Approach to Intra-Antral Pathology.

Brady J Anderson¹, Scott M Graham¹, Brian Andrews¹

¹Department of Otolaryngology, University of Iowa, Iowa City, USA.

The Annals of Otology, Rhinology, and Laryngology

|December 15, 2025

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This study adapted a dental bony window approach for maxillary sinus surgery, successfully reconstructing the bone lid with plates. This technique may overcome previous complications like fistulas and asymmetry.

Area of Science:

Otolaryngology
Oral and Maxillofacial Surgery
Surgical Innovation

Background:

The maxillary bony window approach, a dental procedure, is adapted for otolaryngology.
Traditional sublabial approaches have drawbacks like oroantral fistula and facial asymmetry.

Purpose of the Study:

To describe the adaptation of the maxillary bony window approach for treating maxillary sinus pathologies.
To evaluate the use of contemporary plating for bony lid reconstruction.

Main Methods:

Four patients underwent en bloc removal of the antero-lateral maxillary wall.
Intra-antral pathology was removed, and bony lid reconstruction used contemporary plating.
Clinical course, complications, and follow-up were reviewed.

Keywords:

Caldwell-Luc bony lid bony window maxillary sinus tumor maxillary wall plating

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Main Results:

Successful surgeries were performed for keratocystic odontogenic tumor, foreign body, bony cyst, and juvenile nasopharyngeal angiofibroma.
Excellent exposure of the maxillary sinus and bony lid reapproximation were achieved.
One patient showed excellent bony lid position with no mucosal thickening on long-term follow-up.

Conclusions:

Re-apposing the bony lid after a sublabial approach may reduce historical drawbacks.
This technique could potentially expand the applications of maxillary sinus surgery.
Further studies with larger cohorts and long-term follow-up are needed.