Abstract:Objective To report the experience of endoscopic resection of maxillary sinus benign lesions via the anterior nasolacrimal recess approach, and to discuss the indication and the clinical outcome of this surgical procedure. Methods 43 hospitalized patients, were enrolled in the study. As for the maxillary lesions, pathological examination identified as inverted papilloma (IP) in 15, fungal maxillary sinusitis in 8, maxillary cyst in 12, antrochoanal polyp in 6, and foreign body of maxillary sinus in 2. Preoperative sinus coronal and axial CT scans were done in all patients. The operation was carried out under local anesthesia. In this approach, an incision was made in the front part of inferior turbinate to make the flap, the nasolacrimal duct was moved inwards, and the lesion in the maxillary sinus was removed. Then, the nasolacrimal duct and inferior turbinate flap was reset. Finally, fenestration was made in the inferior nasal meatus. Results The maxillary lesions were removed completely in all 43 patients via this approach. The postoperative followup time ranged from 6 to 24 months. The inferior turbinates were in good shape, and sinus cavities were epithelized without epiphora, facial numbness and other complications. Two IP patients had local recurrence 6 months after operation, received reoperation via original approach and none recurred after following up of 18 months. Three patients had postoperative nasal cavity adhesion, and got healed by partial separation without recurrence. Conclusion Endoscopic resection of maxillary benign lesions via the anterior nasolacrimal recess approach is minimally invasive, safe, and effective. It can be used as a preferable method when the maxillary benign lesions can not be completely removed via endoscopic middle meatal approach.