ABSTRACT
Contemporary surgery of the maxillary sinus focuses almost exclusively on manipulations of the natural ostium for the treatment of medically resistant disease. Options for the surgeon include a complete or partial uncinectomy, simple exposure of the natural ostium and a variety of degrees of surgical manipulations of the ostium. Some surgeons even make decisions about the fate of the middle turbinate based on its capacity for lateralization and ostial occlusion. Septal surgery or reduction of a concha bullosa may aid surgical exposure of the maxillary sinus ostium. More recent options of balloon ostioplasty, approached either transnasally or via the canine fossa, stretch, tear or dilate the ostium and may fracture or displace the uncinate. Older interventions such as antral puncture, inferior meatal window and the Caldwell-Luc operation are used only for the most select of indications.
