ENDOSCOPIC AND CALDWELL-LUC APPROACHES IN CHRONIC MAXILLARY SINUSITIS- A COMPARATIVE HISTOPATHOLOGIC STUDY ON PREOPERATIVE AND POSTOPERATIVE MUCOSAL MORPHOLOGY

The aim of the present investigation was to study the histopathologic mucosal changes occurring in chronic maxillary sinusitis both preopera tive and postoperative to functional endoscopic sinus (FES) surgery an d the Caldwell-Luc (C-L) operation. Correlations were also sought betw een the histopathologic parameters and endoscopic findings, as well as patient symptoms. Sixty sinuses with the FES surgery and 55 sinuses w ith the C-L procedure were studied. The histologic parameters were gra ded semiquantitatively and compared preoperatively and postoperatively . The C-L operation reduced almost all parameters, whereas after the F ES operation only edema and inflammatory cells were significantly redu ced. Fibrosis increased postoperatively with both methods. The number of inflammatory cells was closely correlated to a thickened antral muc osa and to purulent secretion. No valid correlations were found when c omparing histology with patient symptoms. All in all, histologic consi derations suggest that asthmatic patients with severe sinonasal polypo sis might benefit from the C-L procedure.