Caldwell-Luc Operation / Intra-Oral Antrostomy
The Caldwell-Luc operation (in the Oral Surgical use of the procedure) is used for the:

  • Reduction of facial fractures especially those involving the orbital floor

In the Ear, Nose & Throat sense, the
Caldwell-Luc procedure is used for:

  • Treatment of chronic sinusitis

  • Removal of antral polyps and cysts & antro-choanal polyps

  • Removal of antral mucocœles

  • A route to the ethmoid and sphenoid sinuses

  • Visualisation of the orbital floor for decompression

  • Various forms of tumour surgery and

Having said this though, this procedure is dying a death as
Functional Endoscopic Sinus Surgery (FESS) is
superceding the
Caldwell-Luc procedure.  It is associated with far less problems (as listed below).

As I have experienced, when patients are given the option of either a
FESS or a Caldwell-Luc, most patients opt
for a
FESS (understandibly).
The procedure can be carried out under Local Anaesthetic though it may be a pleasanter experience all round for it
to be carried out under
General Anaesthetic.

A small cut is made between the upper lip and gum and a bony window is made (giving access to the
) in the anterior wall of the maxillary sinus.

The natural opening of the sinus into the nasal cavity is often enlarged at the same time to improve drainage of
normal secretions and reduce the chance of recurrent disease.

Occasionally, a new opening (
naso-antral window) is also created between the nose and maxillary sinus.
This list of warnings might seem excessive to some however the legal ruling in the case of Chester vs Afshar
would suggest that it is quite prudent / necessary to list them.  Others might say that there isn't enough
information but where do you stop?

The following list of warnings regarding the
Caldwell-Luc operation is neither exhaustive nor is it predictive.

These are the commoner risks. There may be other unusual risks that have not
been listed here.  Please ask your
Oral Surgeon if you have any general or
specific concerns.

Common Complications:

  • Pain
  • Sutures
  • Trismus
  • Infection
  • Adjacent teeth damaged whilst making hole into the Sinus
  • Bruising / Black Eye

  • Facial swelling

  • Pain ± numbness of the face (infra-orbital neurapraxia).  This is numbness of the cheek and not weakness,
    which always occurs temporarily but rarely persists and

  • Pain ± numbness (temporary / permanent) of the upper teeth (incisors around to the bicuspids) and the
    associated gums

Less Common Complications:

  • Overflow of tears (epiphora) due to blockage of the tear duct and

  • Tooth root injury leading to tooth death (devitalisation) & tooth discoloration

Rare Complications:

  • Facial asymmetry due to persistent facial swelling attributed to scarring and thickening of the facial tissues
    (possibly due to escaped lymphatic fluid from the damaged lymphatic channels following excessive retraction of
    the cheek).

  • Prolonged maxillary sinusitis.

  • Post-op bleeding from the sinus / nose requiring packing of the sinus / nose or even a blood transfusion.

  • Blindness (if the eye socket is entered) & reduced sharpness of vision & movement of the eye (ocular

Useful Articles & Website:

JCDA 2005.  Endoscopically Assisted Caldwell-Luc Procedure for Removal of a Foreign Body from the Maxillary

Archives Orofacial Sci 2008.  Case Report.  Removal of extensive maxillary dentigerous cyst via a Caldwell-Luc

Australian & New Zealand Journal of Surgery 2008.  Complications Of The Caldwell-Luc Operation And How To
Avoid Them.

Clinical Dentistry & Research 2011.  Ectopic Molar Tooth in the Maxillary Sinus.  A Case Report

JOMS 2012.  Caldwell-Luc Operation without Inferior Meatal Antrostomy - A Retrospective Study of 50 Cases

Braz J Otorhinolaryngol 2014.  Case Report.  Late displacement of a dental implant into maxillary sinus

Indian J Otolaryngol Head Neck Surg 2016.  Caldwell Luc Surgery - Revisited

Int J Case Studies in Clin Res 2017.   Foreign Body Displacement for the Maxillary Sinus & Surgical Removal by the
Caldwell-Luc Technique - Clinical Case

OHDM 2017.  Dental Bur into the Maxillary Sinus - A Case Report

Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery 2017.  Caldwell-Luc (Radical Antrostomy),
Inferior Meatal Antrostomy & Canine Fossa & Inferior Meatus Punctures

New York Eye & Ear Infirmary - ENT Academic Faculty
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Last Updated 13th February 2020