Two-Plate Reconstruction of Lateral-Posterior Wall Defects for Functional Recovery of the Maxillary Sinus

Mucociliary clearance (MCC) is essential for the normal physiological function of the maxillary sinus. Maxillary sinus lateral-posterior wall defects, often caused by benign tumor excision or cyst enucleation in the posterior maxilla, can severely impair MCC. Therefore, reconstruction of these defects is necessary to restore sinus function and maintain its original volume. This study introduces a technique for maxillary sinus lateral-posterior wall reconstruction using 2 plates and evaluates its efficacy in maintaining normal sinus function and volume.

This retrospective study included 19 patients who underwent removal of benign tumors or cysts in the posterior maxilla, followed by 2-plate reconstruction of the maxillary sinus lateral-posterior wall. Waters view radiographs were obtained preoperatively (T0), immediately postoperatively (T1), and at 1 month (T2), 3 to 4 months (T3) and 6 to 10 months (T4) postoperatively. The volume and radiopacity of the maxillary sinus were evaluated using Waters view. Sinus density and dimensional changes were analyzed using Adobe Photoshop 2022 (Adobe Systems Inc., San Jose, CA). Anatomical reconstruction was verified through radiographic analysis, while changes in physiological function and clinical outcomes were assessed via patient symptom evaluation.

Radiographic haziness increased at T1 compared to T0, followed by a gradually decreasing trend; however, there was no statistically significant difference between T0 and T4. No significant postoperative changes in maxillary sinus volume were observed, demonstrating stable volume maintenance. At 10 months postoperatively, the number of patients experiencing clinical discomfort significantly decreased. In 11 patients, the plates were removed at an average of 2.5 years after the initial surgery.

In patients with lateral-posterior wall defects of the maxillary sinus, 2-plate reconstruction effectively maintains the original sinus volume by preventing hypertrophic fibrous scarring, thereby restoring normal mucociliary function.