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Antral washout

Maxillary sinus washout (Figure 44) has been performed for many years. It may be done under local anaesthesia obtained by the use of cocaine spray and paste, or under general anaesthetic. A specially-designed needle with a sheath (trochar and cannula) is employed. The trochar and cannula are inserted under the inferior turbinate through a relatively-thin point in the bone which separates the maxillary sinus from the inferior meatus of the nose. Once the sinus has been penetrated, the sharp trochar is withdrawn and the cannula or sheath is used for irrigation. A specimen of any pus within the antrum may be withdrawn first, and the antrum is then irrigated with a solution of saline to wash out any infected secretion in its cavity. In mild cases of maxillary sinusitis which have persisted following failed medical treatment, releasing the load of infected secretion from the sinus may be sufficient to secure a return to normal function, particularly when combined with the use of an appropriate antibiotic as determined by examination of the pus in the microbiology laboratory.