Posterior translacrimal approach to the maxillary sinus

Background: This study aimed to compare the view into the maxillary sinus using the posterior translacrimal approach compared with grade 3 antrostomy. Methods: Grade 3 antrostomy followed by a posterior translacrimal approach was performed on four cadavers. The maximum intramaxillary view was documented endoscopically guided by electromagnetic navigation. Representative screenshots were evaluated in a blinded manner by three independent sinus surgeons. In addition, a prospective investigation of specific complications in the post-operative course of consecutive patients was performed. Results: In the cadaver study, the posterior translacrimal approach provided a significantly better view into the maxillary sinus compared with grade 3 antrostomy. In the clinical study, only 1 out of 20 patients reported on a minor problem with lacrimal drainage at 6 months. Conclusion: The posterior translacrimal approach to visualising the maxillary sinus should be considered a strong alternative to more radical techniques.