Maxillary Recirculation

Recirculation phenomenon is a common cause of failure in endoscopic sinus surgery.

This occurs when secretions transported out of the natural maxillary ostium return to the sinus via a surgically created or accessory ostium.

The putative mechanism of sinus disease related to this recirculation involves the repeated presentation of allergens, bacteria, and inflammatory mediators contained in the mucus. If the mucus is not cleared, its viscidity increases, and its concentration of inflammatory agents also increases its potential for inducing sinus mucosal inflammation and disease. (1)

To correct this, the intervening band of mucosa should be taken down to enlarge the antrostomy and to eliminate the cause of the recirculation.

References

• (1) Matthews BL, Burke AJ. Recirculation of mucus via accessory ostia causing chronic maxillary sinus disease. Otolaryngol Head Neck Surg 1997;117:422-3.