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Head and Neck Imaging

Caldwell-Luc procedure

(George W. Caldwell, 1834-1918, American physician; Henri Luc, 1855-1925, French laryngologist), intraoral procedure for entering the maxillary antrum through the canine fossa above the maxillary premolar teeth. After opening of the maxillary antrum, the sinus mucosa is stripped from the sinus wall. Additionally, an intranasal antrostomy is made (Fig. 1). This procedure used to be commonly performed for chronic maxillary sinusitis, but has now been largely replaced by functional endoscopic sinus surgery .
Postoperatively, the sinus walls may thicken as a result of reactive bone formation; the sinus walls may also collapse, narrowing the antral cavity. Postoperative synechiae may develop within the antral cavity, possibly causing compartmentalization of the cavity and formation of postoperative mucocele (Fig. 2).

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Fig. 01

Coronal CT-image. Surgical defects in the anterolateral maxillary wall (arrows), and in the medial wall at the level of the inferior nasal meatus (antrostomy, arrowhead). A polipoid inflammatory mass is present in the left maxillary sinus, protruding through the antrostomy in the nasal cavity; inflammatory pathology in the other paranasal sinuses.
Caldwell-Luc procedure, Fig. 01
Caldwell-Luc procedure, Fig. 02