title: Video endoscopic oro-nasal visualisation of the anterior wall of maxillary sinus: a new technique.
abstract: The anterior wall of the maxillary sinus represents a blind spot in maxillary sinus endoscopic surgery because of the absence of proper visualisation and instrumentation to reach it. The aim of this study was to validate a new approach through the oral cavity into the nose with a flexible video endoscope (oro-nasal endoscopic approach; ONEA) to visualise the entire anterior maxillary wall including the anteromedial angle. We started from a dried bone cadaver model, and then dissected fresh-frozen cadavers. The maxillary sinus was explored with a rigid and a flexible endoscope entering from the nose. Next, a flexible endoscope was introduced through the mouth and back up through the choana, it accessed the maxillary middle antrostomy, entering inside the sinus and looking at the anterior wall. A small ruler inserted inside the sinus demonstrated all the angles visualised. The new ONEA technique allows complete visualisation of the anterior wall of the maxillary sinus with inspection of all blind spots. It is therefore possible to detect lesions that would normally not be visible with a normal rigid endoscope. We demonstrate the validity of a novel technique that allows visualisation of the infero-medial angle of the anterior wall of the maxillary sinus.
authors.affiliation: Department of Otorhinolaryngology, San Raffaele Scientific Institute and Vita-Salute University, Milano, Italy;
authors.forename: M
authors.initials: M
authors.lastname: Trimarchi
authors.affiliation: Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University Graz, Graz, Austria;
authors.forename: P V
authors.initials: PV
authors.lastname: Tomazic
authors.affiliation: Department of Otorhinolaryngology, San Raffaele Scientific Institute and Vita-Salute University, Milano, Italy;
authors.forename: G
authors.initials: G
authors.lastname: Bertazzoni
authors.affiliation: International Biological, Inc, Detroit, Michigan, USA.
authors.forename: A
authors.initials: A
authors.lastname: Rathburn
authors.affiliation: Department of Otorhinolaryngology, San Raffaele Scientific Institute and Vita-Salute University, Milano, Italy;
authors.forename: M
authors.initials: M
authors.lastname: Bussi
authors.affiliation: Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University Graz, Graz, Austria;
authors.forename: H
authors.initials: H
authors.lastname: Stammberger
mesh_terms: D002102:Cadaver; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D008443:Maxillary Sinus / Q000033:anatomy & histology*; D009055:Mouth; D009666:Nose; D014741:Video Recording
keywords: Cadaver dissection; Endoscopic surgery; Endoscopy; Maxillary sinus; Oro-nasal endoscopic approach (ONEA)