Brief about Caldwell-Luc Procedure

Today in this article we will learn brief about caldwell - luc procedure.

Caldwell - Luc  Procedure:

 George Caldwell (1893) and Henri Luc (1897) described a new method of entering into the maxillary sinus. Two separate openings are made.One in the  canine fossa to gain access to the antrum and other in the nasoantral wall for drainage.Therefore, it is a method of gaining entry into the maxillary sinus via canine tossa with nasal antrostomy.

Indications:

1. Removal of root fragment or teeth or foreign body from the maxillary sinus.
2. Removal of cyst or benign growth.
3. Removal of impacted canine or 3rd molar.
4. Treatment of chronic maxillary sinusitis.
5. Closure of chronic oroantral fistula.
6. Management of hematona in maxillary sinus and post traumatic hemorrhages in the sinus.
7. Zygomaticomaxillary complex fractures.

Instruments:

1. Refractors
2. Nasal speculum
3. Periosteal elevator
4. Gauge
5. Nasal trocar
6. Kerrison or backbiting tarceps
7. Rongeurs
8. Antral rasp
9. Antrum curettes

Surgical Procedure:

1. Procedure can be performed under LA with sedation or under GA.
2. Semilunar incission is made in the buccal vestibute from the canine to 2nd molar area.
3. Mucoperiosteal flap is raised with periosteal elevator till the infra orbital ridge.
4. An opening or window is created in the anterior wall of maxillary sinus with the help of chisel, gauges or dental drills.
5. The opening is enlarged in all direction with Rongeur forceps.
6. Pus/blood is drained from the sinus and through irrigation is done with saline wash.
7. Inspection of maxillary sinus is done and removal of root, tooth, gauze, cotton or bone wax etc.
8. Infected lining of maxillary sinus can be elevated with Howorth's periosteal elevator and removed and seal for histopathological examination.
9. If there is profuse bleeding, then the sinus can be placed with ribbon gauze soaked in adrenaline for 1 or 2 minutes.
10. The antral cavity is again irrigated.
11. The incission is closed with 3-0 silk luture.

Post Operative Management:

1. Antibiotics, analgesics, anti-inflammatory drugs for 5 days.
2. Suture removal on 5th day.
3. Tinc, benxoin inhalation 3 times/day followed by nasal drops.
4. Patients instructed not to blow the nose, have soft diet, and avoid vigorous gargling.