J Rhinol.  2019 May;26(1):52-55. 10.18787/jr.2019.26.1.52.

Treatment of Facial Neuralgia Developed after Inferior Meatal Antrostomy by Narrowing of the Inlet with Endoscopic Cartilage Graft

• Yi JS
• Jin HR

• KMID: 2449030
• DOI: http://doi.org/10.18787/jr.2019.26.1.52

Abstract

Inferior meatal antrostomy (IMA) is a widely performed surgical technique to treat postoperative maxillary mucocele. The method is safe and easy to perform, without major complications compared with other approaches. Facial pain after IMA is a rare clinical entity that can be challenging to diagnose and treat. The authors present an unusual case of acute facial neuralgia triggered by cold air that developed after IMA. The antrostomy was located at the anterior-most part of the inferior meatus, and the inlet size was relatively large compared with the size of the remaining sinus. Surgical narrowing of the antrostomy inlet using endoscopy dramatically reduced the symptoms, and symptom relief was maintained for up to one year after surgery.

Keyword

Facial pain; Caldwel-Luc operation; Inferior meatal antrostomy; Inferior orbital nerve dehiscence

MeSH Terms

Bays*
Cartilage*
Endoscopy
Facial Neuralgia*
Facial Pain
Methods
Mucocele
Transplants*

Figure

• 

  Fig. 1 OMU CT scan showed small, contracted left maxillary sinus with fibrosis and new bone formation. The antrostomy inlet is relatively large compared to the small sinus.

• 

  Fig. 2 IMA site reconstruction. A: About 1.0 cm sized, patent antrostomy at the anterior part of the left inferior meatus, B: endoscopic vestibular incision, C, D: dissection of pocket, E: insertion of cartilage chips, F: ostium narrowing after surgery.

• 

  Fig. 3 Pre (A) and postoperative 6 months (B) endoscopic view of the IMA opening. Narrowed antrostomy inlet was well maintained. IT: inferior turbinate, NF: nasal floor

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