Caldwell-Luc Procedure:
Content provided by Steven Schaefer, M.D.
Department of Otolaryngology/Head and Neck Surgery
The New York Eye and Ear Infirmary
Definition
Caldwell-Luc is the fenestration of the anterior wall of the maxillary sinus and the surgical drainage of this sinus into the nose via an antrostomy. This procedure was first described by George Caldwell in 1893 of New York, and to the best of our knowledge employed by him as a staff member of The New York Eye & Ear Infirmary.
Four years later Henri Luc of Paris described the same operation, and the procedure is now referred to as a Caldwell-Luc. Over the subsequent eighty years, this procedure became the “work horse” of much of sinus surgery (Macbeth, 1968). With the introduction of endoscopic sinus surgery, Caldwell-Luc is much more selectively employed as intranasal approaches often permit excellent access to the maxillary sinus. In the past
Caldwell-Luc was used for treatment of chronic sinusitis, removal of polyps, cysts or foreign bodies, reduction of facial fractures, closure of dental fistulas into the maxillary sinus and as a route to the ethmoid and sphenoid sinuses. Other applications of Caldwell-Luc include visualization of the orbital floor for decompression, various forms of tumor surgery and access to the pterygomaxillary fossa (the space behind the maxillary sinus [Ogura, 1962]).
Current indications for Caldwell-Luc include:
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Exposure and removal of tumors within or adjacent to the maxillary sinus
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Removal of odontic tumors or cysts (from tooth- forming tissues), and
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Occasionally the more conventional indications prior to endoscopic sinus surgery as judged by the surgeon and their experience with the various approaches.
Coronal CT scans shows a dense, irregular mass within the floor of the right maxillary sinus. The inferior aspect of the sinus is filled with soft tissue suggesting infection or abnormal growth of tissue accompanying the mass.
A second CT scan shows reveals a tooth-like structure within the floor of the maxillary sinus. This radiograph and subsequent surgery was consistent with a dentigerous cyst. This cyst has arisen from the crown area of an unerupted tooth. The Caldwell-Luc approach was used to expose and remove this impacted tooth and the cyst
View intraoperative and cadaver illustrations on this topic.
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