The Caldwell-Luc operation

OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD &
NECK OPERATIVE SURGERY

CALDWELL-LUC (RADICAL ANTROSTOMY) , INFERIOR MEATAL ANTROS -
TOMY & CANINE FOSSA AND INFERIOR MEATUS PUNCTURES
Johan Fagan

The Caldwell-Luc operation involves
creating an opening into the maxillary
antrum through the canine fossa via a
sublabial approach.

Canine fossa (CFP) & inferior meatal
puncture are used to obtain samples of pus
from the antrum, to irrigate the antrum
(“antral washout”), or as an adjunct to en-
doscopic ethmoidectomy.


Surgical anatomy

The Caldwell-Luc operation involves en-
tering the maxillary sinus via an opening in
the thin bone of the canine fossa (Figures
1-3).


Figure 1: Thin bone of canine fossa (yel-
low arrow); nasolacrimal duct (red arrow)

A series of eminences overlie the roots of
the teeth on the inferior part of the face of
the maxilla (Figures 2, 3). Just above the
eminences of the incisor teeth is a depres-
sion called the incisive fossa; it gives ori-
gin to the depressor alae nasi. The nasalis
muscle arises just lateral to it (Figure 2).


The canine fossa is a depression on the
anterior surface of the maxilla below the
infraorbital foramen and lateral to the ca-
nine eminence and the incisive fossa
(Figures 2, 3). It is larger and deeper than
the incisive fossa, and is separated from it
by the canine eminence, a vertical mound
overlying the socket of the canine tooth.
The caninus muscle arises from the canine