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An antrostomy is a surgical procedure in which the maxillary sinus is opened so that it can drain properly, while also being cleared out by the surgeon to remove materials which may have contributed to inflammation. It can be combined with surgery to fix a deviated septum in order to address chronic nasal and sinus problems. This procedure is usually performed by an ear, nose, and throat (ENT) surgeon who specializes in handling surgical procedures of this nature.
A patient who needs an antrostomy usually has recurrent sinusitis, in which the sinuses become inflamed repeatedly. The inflammation causes pain around the cheekbone which may migrate down towards the jaw. It also leads to blockage of the sinus, which can cause infection to set in as bacteria become trapped with no outlet. Antibiotic medications can sometimes resolve the problem, but in other cases, antrostomy and other sinus surgeries may be required. As with any surgery, there are risks to an antrostomy, but they can be reduced by working with experienced surgical teams.
In an antrostomy, the surgeon's goal is to reopen the sinus so that it can drain. Sometimes, a new drain must be put in place because the sinus cannot drain normally at the usual location. The surgery starts with a patient evaluation in which the nose is inspected, medical imaging studies are taken, and the patient meets with an anesthesiologist for the purpose of discussing anesthesia problems.
The surgery itself lasts from one to three hours, with the patient under general anesthesia. The surgeon uses an endoscope to insert tools up the nose to reach the maxillary sinus in a minimally invasive technique. The sinus is drained and cleared, and the surgeon inspects the area for any signs of irregularities which might contribute to sinus infections and other problems. At the conclusion of the surgery, the patient can be taken into recovery and monitored while he or she wakes up.
Antrostomy is usually an outpatient procedure. Once the patient is awake and comfortable, he or she can be sent home. It is usually advised that arrangements for a ride be made ahead of time, because the patient may be too dazed to drive comfortably or safely. The creation of a surgical opening for sinus drainage should help reduce the risk of maxillary sinusitis in the future because the sinus will be able to drain freely, limiting buildup of materials which lead to inflammation. The patient will also be given antibiotics to limit infection.