Chronic rhinosinusitis: is any indication for Caldwell-Luc approach in endoscopic sinus surgery era?


  • Daniel Lupoi Department of ENT, Sfanta Maria Hospital, Bucharest Carol Davila, University of Medicine and Pharmacy, Bucharest



Caldwell-Luc, Endoscopic sinus surgery, Maxillary sinus


Background: Caldwell-Luc procedure was the gold standard procedure for chronic maxillary sinusitis until the endoscopic sinus surgery developed more and more. The aim of this study was to show the importance of Caldwell-Luc surgical approach in endoscopic sinus surgery era.

Methods: Prospective study between 2009 and 2019 in the ENT Department of the Clinical Hospital Sfânta Maria from Bucharest. The inclusion criteria were as follows: adult patients diagnosed clinical and paraclinical with isolated chronic maxillary rhinosinusitis in whom correctly conducted drug treatment failed and, according to current therapeutic guidelines, had indication for surgical treatment. The treatment method consisted of a surgical approach, which was classic or endoscopic, depending on the situation imposed on each patient.  

Results: The application of the inclusion criteria in the study led in a group of 521 patients, of which 282 men (54.12%) and 239 women (45.87%). Following the accounting of the days of hospitalization and those of medical leave at discharge, a number of days of absenteeism of 13.85 days resulted in the case of patients treated classically and 8.62 days for those treated endoscopically. Also the endoscopic group had a better endoscopic and VAS score postoperatively.

Conclusions: Surgical treatment of maxillary sinus can be minimally invasive- endoscopic, extended endoscopic or classical open surgery. Open classic surgical treatment remains the last treatment alternative, with indication for rhinosinusal recurrences or the imminence of complications. Endoscopic surgery is the “gold standard” for chronic maxillary rhinosinusitis.



Salama N, Oakley RJ, Skilbeck CJ, Choudhury N, Jacob A. Benefit from the minimally invasive sinus technique. J Laryngol Otol. 2009;123(2):186-90.

Masterson L, Agalato E, Pearson C. Image-guided sinus surgery: practical and financial experiences from a UK centre 2001-2009. J Laryngol Otol. 2012;126(12):1224-30.

Levine H, Clemente M. Surgical Approaches: Endonasal Endoscopic. In: Sinus Surgery Endoscopic and Microscopic Approaches. Thieme Medical Publishers; 2005:156.

Stammberger H, Posawetz W. Functional endoscopic sinus surgery: Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol. 1990;247(2).

Levine H, Clemente M. Surgical Approaches: Endonasal Endoscopic. In: Sinus Surgery Endoscopic and Microscopic Approaches. Thieme Medical Publishers; 2005:158.

Lee JY, Lee SW. Influence of age on the surgical outcome after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope. 2007;117(6):1084-9.

Busaba NY. The impact of a patient’s age on the clinical presentation of inflammatory paranasal sinus disease. Am J Otolaryngol. 2013;34(5):449-53.

Young J, Frenkiel S, Tewfik MA, Mouadeb DA. Long-term outcome analysis of endoscopic sinus surgery for chronic sinusitis. Am J Rhinol. 2007;21(6):743-7.

Hoffman D, May M, Mester S. Functional endoscopic sinus surgery- experience with the initial 100 patients. Am J Rhinol. 1990;4:129-32.

Goldstein GH, Kennedy DW. Long-term successes of various sinus surgeries: a comprehensive analysis. Curr Allerg Asthma Rep. 2013;13(2):244-9.

Russell P, Becker S. Caldwell-Luc Surgery. In: The Maxillary Sinus: Medical and Surgical Management. Thieme Medical Publishers; 2010:36.

Bajan A, Sarafoleanu C, Melinte VG, Decuseara R. Indications of the Caldwell-Luc procedure in the era of endoscopic sinus surgery. Romanian J Rhinol. 2020;10(39):78-84.






Original Research Articles