Nasal Suction Technique for Maxillary Sinus Floor Elevation: A Report of 24 Consecutive Patients

Purpose: Inadvertent perforation of the sinus membrane is a frequent complication encountered during sinus floor elevation (SFE). Different strategies have been described for the prevention or treatment of perforations, with varying results. This paper reports the findings of a preliminary study into the application of a novel nasal suction technique in which negative antral air pressure was used to facilitate the raising of the sinus lining and to reduce the risk of perforations occurring during SFE. Materials and Methods: In 24 consecutive patients, nasal suction was applied through the ipsilateral nostril during SFE. The suction device was attached to a high-flow vacuum regulator that incorporated a suction canister connected to a -10-kPA medical vacuum (-75 mm Hg). Fifteen subjects received unilateral SFE, and six subjects had bilateral staged lateral wall sinus elevation; the remaining three subjects had osteotome sinus floor elevation (three unilateral and one bilateral) with simultaneous implant placement. Results: During SFE, the use of nasal suction facilitated the inversion of the sinus lining around the edges of the lateral access window. This made the sinus lifting easier, as the need for extensive instrumentation was significantly reduced. In three subjects, elevation of the sinus lining occurred spontaneously from the lateral, medial, and inferior surfaces of the antrum when nasal suction was applied. Conclusion: Sinus lifting was facilitated by nasal suction. No perforation of the sinus lining occurred in this series. Controlled clinical trials are being designed to further demonstrate the clinical efficacy of the nasal suction technique in SFE. Keywords: nasal suction, sinus grafting, sinus lift, sinus membrane elevation, sinus membrane perforation