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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. 02

Coronal contrast-enhanced CT-image. Patient presenting with right-sided paranasal swelling, several years after a Caldwell?Luc procedure. Expansile lesion with contrast-enhancing rim is seen within the right maxillary sinus; it bulges through the surgical defects in the canine fossa and into the nasal cavity. Focal demineralization and displacement of the orbital floor. Postoperative mucocele.
Caldwell-Luc procedure, Fig. 01
Caldwell-Luc procedure, Fig. 02