title: Canine fossa trephine is a beneficial procedure in patients with Samter`s triad.
abstract: BACKGROUND
  Canine fossa trephine (CFT) is an adjunctive technique to sinus surgery in patients with recalcitrant maxillary sinusitis. CFT allows for disease clearance in areas of the maxillary sinus that are hard to reach with standard endoscopic techniques. The objective of this study was to compare the surgical outcome of CFT to standard middle meatal antrostomy (MMA) in matched patients with the severely diseased maxillary sinus.
  
  
  METHODS
  Prospective clinical study
  
  
  METHODS
  Patients undergoing sinus surgery were enrolled in either the CFT or MMA group. All patients had nasal polyps, Lund Mackay score of 2 in the maxillary sinus, and nasal endoscopy showing the maxillary sinus full of polyps. The patients were followed and the maxillary sinus was graded endoscopically at 3, 6 and 12 months after the surgery. Length of surgery, disease recurrence and need for revision surgery was documented.
  
  
  RESULTS
  Forty-two CFTs and MMA were performed in each group. At 6 and 12 months the CFT group demonstrated statistically significant improvement in nasal endoscopy scores. Six patients recurred by the one year mark in the MMA group, 4 of which underwent revision surgery. In the CFT group 2 patients recurred, one who underwent a unilateral revision CFT. Furthermore the CFT did not prolong the surgical time and was often faster than performing a MMA.
  
  
  CONCLUSIONS
  CFT allows for clearance of all gross disease in the maxillary sinus and appears to improve postoperative outcome at 6 and 12 months and decrease the need for revision surgery.
authors.affiliation: Department of Otolaryngology, Loma Linda University Medical Center, Loma Linda, CA, USA.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Seiberling
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Church
authors.forename: Marc
authors.initials: M
authors.lastname: Tewfik
authors.forename: Andrew
authors.initials: A
authors.lastname: Foreman
authors.forename: Dennis
authors.initials: D
authors.lastname: Chang
authors.forename: Michelle
authors.initials: M
authors.lastname: Ghostine
authors.forename: Peter John
authors.initials: PJ
authors.lastname: Wormald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery*; D015523:Maxillary Sinusitis / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D012008:Recurrence; D014207:Trephining; D055815:Young Adult