# Endoscopic Prelacrimal Approach for the Surgical Management of a Late Silicone Foreign Body and an Odontogenic Maxillary Cyst: A Case Report

## TL;DR

A new endoscopic surgical approach successfully removed hard-to-reach foreign bodies and cysts in the maxillary sinus, offering a safe and effective treatment option.

## Contribution

The paper introduces the endoscopic prelacrimal recess approach for managing difficult maxillary sinus pathologies.

## Key findings

- EPLA enabled complete removal of a retained silicone fragment and an odontogenic cyst in two patients.
- The approach preserved critical anatomical structures without complications.
- Postoperative outcomes showed complete symptom resolution in both cases.

## Abstract

Foreign bodies and odontogenic lesions of the maxillary sinus can lead to chronic rhinosinusitis, particularly when located in compartments that are difficult to access surgically. We report two cases managed using the endoscopic prelacrimal recess approach (EPLA). The first case involved a 76-year-old woman presenting with chronic facial pain and purulent discharge caused by a retained silicone fragment following bilateral inferior turbinectomy performed 20 years earlier. The second case concerned a 28-year-old woman with recurrent left maxillary sinusitis secondary to a 2.1-cm pericoronal cyst associated with an ectopic tooth. In both patients, EPLA allowed direct access to the anterior and inferior maxillary sinus, enabling complete lesion removal while preserving the nasolacrimal duct, natural ostium, and inferior turbinate. Postoperative outcomes were favorable, with complete symptom resolution and no reported complications. These cases demonstrate the feasibility and safety of the endoscopic prelacrimal recess approach for selected maxillary sinus pathologies located in anatomically challenging compartments.