Is the Caldwell-Luc operation and its modifications still useful in the era of endoscopic sinus surgery? Findings from a resource-limited setting

Introduction
Despite the advent of endoscopic sinus surgery, an external approach to the maxillary sinus may be ideal in certain situations. Objectives: This retrospective study reviews the relevance of, and the indications for, an external approach to the maxillary sinus via Caldwell-Luc operation or its modifications in a health resource-limited setting.

Material and methods
Data from case notes and operating records of patients who had the Caldwell-Luc opera¬tion or its modifications between January 2004 and June 2018 at the Department of Maxillofacial Surgery of a University Teaching Hospital were retrospectively studied. Findings from descriptive statistics are represented in the form of tables and charts.

Results
A total of 26 patients had the Caldwell-Luc operation within the period reviewed, and this consisted of 16 (61.5%) males and 10 (38.5%) females, giving a male to female ratio of 1.6 : 1. Patients’ ages ranged from 10 to 45 years with a mean of 31.0 ± 8.8 years. The paediatric age group accounted for only 11.5% of cases. The main indication for performing the Caldwell-Luc operation was chronic maxillary sinusitis (n = 14; 53.8%), and occipitomental radiograph (n = 24; 92.3%) was the main imaging modality used for assessment. Compliance with follow-up review was poor.

Conclusions
Despite the advent of functional endoscopic sinus surgery, an external approach to the maxillary sinus using the Caldwell-Luc operation is still relevant, especially in health resource-limited settings.