Endoscopic surgery of the nasal fontanel. A new approach to recurrent sinusitis

For the treatment of recurrent maxillary sinusitis, the middle meatus offers a good site to make an extra ostium, ie, the posterior nasal fontanel. The fontanel is situated near the natural maxillary ostium in the middle meatus, and this site is a more physiologic place, therefore, to create an antrostomy compared with the inferior meatus. Moreover, a surgical ostium has little inclination to become obliterated in this area. A special instrument was designed to perforate the fontanel. Nasoendoscopy gives an excellent view of the area and makes it possible to avoid complications.