title: Canine fossa puncture and clearance of the maxillary sinus for the severely diseased maxillary sinus.
abstract: OBJECTIVE
  To assess the impact of canine fossa puncture (CFP) with clearance of the maxillary sinus during endoscopic sinus surgery on the subjective and objective outcomes as defined by quality of life questionnaires, endoscopic findings, endoscopic aspirate for culture and sensitivity, and magnetic resonance imaging (MRI) evaluation.
  
  
  METHODS
  Retrospective, cross-sectional study.
  
  
  METHODS
  Twenty-five patients who had undergone canine fossa were compared to 12 patients who had undergone routine endoscopic middle meatal clearance of the maxillary sinus. At an average postoperative time point of 19.9 months, all patients were administered the chronic sinusitis survey (CSS) and a visual analogue scale (VAS). At this visit, patients underwent nasendoscopy, sampling of the ostial region for bacterial and fungal cultures, and MRI of the sinuses.
  
  
  RESULTS
  There were 42 sides for analysis from 25 patients on the study arm; the control arm comprised 12 patients with completely opacified maxillary sinuses and 17 sides for analysis. The CSS symptom subscore was better in the CFP group (Mann-Whitney test, P = .02). The overall VAS score was less in the CFP group (Mann-Whitney test, P = .01), indicating better symptom control. No opacification was evident in 61.9% of patients in the CFP group compared with 11.8% in the control arm (chi, P < .001).
  
  
  CONCLUSIONS
  CFP is a useful technique to address the severely diseased maxillary sinus and is associated with significantly better symptom control compared with the transnasal middle meatal antrostomy clearance of the maxillary sinus.
authors.affiliation: Department of Surgery-Otolaryngology Head and Neck Surgery, University of Adelaide, Woodville, South Australia.
authors.forename: Shanmugam
authors.initials: S
authors.lastname: Sathananthar
authors.forename: Smita
authors.initials: S
authors.lastname: Nagaonkar
authors.forename: Vinidh
authors.initials: V
authors.lastname: Paleri
authors.forename: Tong
authors.initials: T
authors.lastname: Le
authors.forename: Simon
authors.initials: S
authors.lastname: Robinson
authors.forename: Peter-John
authors.initials: PJ
authors.lastname: Wormald
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004724:Endoscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery*; D015523:Maxillary Sinusitis / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D010147:Pain Measurement; D011677:Punctures; D012189:Retrospective Studies