Caldwel luc operation

Caldwel luc operation

Caldwel luc operation

Caldwel luc operation is .process of opening maxillary antrum through canine fossa by sublabial approach and dealing with the pathalogy inside antrum

indications  

1. Chronic maxillary sinusitis with changes in sinus mucosa
2.Removal of foreign bodies or root of tooth
3.Dental cyst
4 oroantral fistula
5. Suspected neoplasm
6  recurrent antrochoanal polyp
7 fracture of maxilla
8 approach to ethmoids
9 approach to pterigopalatine fossa

contraindications

patient below 17 yrs age

Anasthesia

general anasthesia with cuffed endotracheal tube and  a pharyngeal pack
local anasthesia can be done

position

reclining with head end of tabel raised . Patient lies supine with  face turned

Technique

1. Incisison
a horizontal incision with its end upward is made below gingivolabial sulcus from lateral incisor to 2nd molar it cuts through mucous membrane and periosteum

2 .Elevation of flap
mucoperiosteal flap is raised from the canines fossa to infraorbital nerve

3. Opening the antrum
using cutting burr hole is in antrum

4 Dealing with pathology
after opening maxillary antrum pathology is removed with elavator and foreceps

5 Making nasoantral window
a curved haemostat is pushed into antrum from inferior meatus
and then opening enlarged with kerrisons and sidebiting foreceps

6. Packing the antrum
ribbon guaze impregnated with liqid parrafin can be packed in antrum and its end brought out from nasoantral window into nose  Intrasinus packing is done if there is severe bleeding

7. Closure of wound
sublabial incision is closed with  catgut sutures

post operative care

1 . Ice packs over cheek in first 24 hours prevent odema haematoma
2  packing in sinus and nose can be removed in 24 to 48 hrs
3antibiotics are given for 5 tn 7 days
4  patient should avoid blowing his nose to avoid surgical emphyesema

complications

1 Post operative bleeding
2 injury to nasolacrimal duct
3 sublabial fistula
4 osteomylitis of maxilla
5 anasthesia of teeth
6 anasthesia of cheek due stretching  of  infraorbital nerve