ENT Surgery: Caldwell-Luc Operation
High-Yield Revision for NEET PG
The Caldwell-Luc procedure is a radical surgical approach used to access the maxillary sinus via the canine fossa. While it has largely been replaced by Functional Endoscopic Sinus Surgery (FESS), it remains an essential procedure for specific, complex pathologies.
1. Indications
- Removal of antrochoanal polyps (specifically their base of origin).
- Management of chronic maxillary sinusitis that is recalcitrant to FESS.
- Retrieval of a foreign body or displaced tooth root from the maxillary sinus.
- Benign tumors (e.g., inverted papilloma or juvenile nasopharyngeal angiofibroma – JNA).
2. Surgical Technique & Anatomy
| Step | Details |
|---|---|
| Incision | Sublabial (gingivolabial) incision. |
| Approach | Fenestration of the canine fossa to enter the sinus. |
| Drainage | Creation of a naso-antral window (meatal antrostomy) for drainage into the nose. |
3. NEET PG High-Yield Pearls
- Complication: The most common complication is infraorbital nerve paresthesia/hypesthesia due to injury during the approach.
- Contraindication: Avoided in children before the permanent dentition has erupted to prevent injury to the developing tooth buds.
- Dentition: Can cause devitalization of maxillary teeth.
- Modern Context: It is historically referred to as “radical antrostomy.” FESS is now the gold standard due to its conservative, tissue-sparing nature.