Table 1.

Indications, contraindications, and ideal cases for selected approaches to the maxillary sinus

Approaches	Indications	Contraindications	Ideal cases
Medial wall maxillary antrostomy/anterior ethmoidectomy	Inflammatory and neoplastic diseases of MS; MS mega‐antrostomies; endoscopic medial maxillectomy; initial step for transpterygoid approach	Malignancy with inability to complete an endoscopic resection	Chronic rhinosinusitis; complications of acute rhinosinusitis; select MS tumors
Caldwell–Luc (anterior transmaxillary approach)	Inflammatory and neoplastic diseases of MS; facial trauma; to reach the pterygopalatine and infratemporal fossa; adjunct to endoscopic cranial base approaches (contralateral transmaxillary); instrument manipulation during endoscopic ipsilateral approaches (to Meckel's cave and infratemporal fossa); pathology in the masticator space or lateral recess of the sphenoid sinus	Anterior wall of MS with severe bone dysplasia; lesion accessible through an endoscopic endonasal approach	Odontogenic neoplasms; MS tumors with attachment in MS anterior wall; facial trauma
Transconjunctival	Maxillofacial trauma; to access the ION or the inferior orbital fissure; adjunctive approach to MS with orbital involvement tumors	Lesion not reachable with transconjunctival incision even with addition of lateral canthotomy	Access to the ION, which may be involved in pathologic processes such perineural invasion from malignancy; zygomatic complex trauma
Transpalatal	Oral cavity malignancies with alveolar or MS involvement; MS boney lesions with extension through the MS floor or palate into the oral cavity (often added to transnasal endoscopic approaches); adjunctive approach to oral‐antral fistula repair	Severe trismus; tumor extends too lateral to midline	Boney lesions along the floor of the MS: intraosseous hemangiomas or odontogenic neoplasms; adjunctive approach to oral‐antral fistula repair
Hemicoronal	To access frontal, temporal, and zygomatic areas; tumors of posterior/lateral wall of MS; transmaxillary access to the central skull base (temporoparietal fascia flap)	Male pattern alopecia (relative contraindication)	Zygomatic complex fractures; tumors of posterior/lateral wall of MS (infratemporal fossa)

Abbreviation: MS, maxillary sinus.