Maxillary Sinus Mucosal Prolapse: A Pilot Study Describing a New Technique for Intraoperative Management

Abstract

Objectve: Functional endoscopic sinus surgery is primarily aimed at restoring the natural physiology of the paranasal sinuses to achieve efective mucociliary clearance and proper ventilation. This can be hindered by various factors, including host-related, environmental, and iatrogenic factors. Preservation of the sinus mucosa is fundamental for the success of the surgery. Sinus mucosal prolapse, resulting from intraoperative mucosal trauma, can lead to sinus ostium obstruction and impaired drainage. Methods: In this pilot study, the authors describe a novel technique for the intraoperative management of sinus mucosal prolapse arising from endoscopic sinus surgery. This method entails the use of a balloon catheter expander to infate and support the maxillary sinus mucosa, thereby limiting the occurrence of preventable prolapse-related complications. Results: The authors applied this surgical technique to a cohort of 11 patients. All patients developed prolapse afecting the posterosuperior region of the maxillary sinus mucosa. Each patient was followed up for at least 3 weeks following the surgery, and endoscopic assessment postoperatively revealed absent mucosal prolapse in all patients, highlighting the success and positive outcomes of the technique. The sinus mucosa retained its appropriate positioning, efectively draping the sinus wall in uninterrupted continuity with the maxillary antrostomy. Conclusion: The authors advocate the use of a Foley catheter as a cost-efective and readily available alternative to the traditional balloon sinus catheter expander.