Contemporary surgical approaches for the closure of maxillary sinus defects with clinical cases from the authors’ practice

Journal of Biomedical and Clinical Research 19: 183-197, doi: 10.3897/jbcr.e189851

Tsvetomir Stoyanov^‡, Boris Duhlenski^‡, Tsvetelin Mishev^‡, Milen Georgiev^§

‡ ENT Clinic, UMHAT "Dr. G. Stranski" – Pleven, Medical University – Pleven, Pleven, Bulgaria§ Medical University – Pleven, Pleven, Bulgaria

Corresponding author: Tsvetelin Mishev ( tsvetelin.mishev@abv.bg )

Academic editor: Paulina Vladova

This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Citation: Stoyanov T, Duhlenski B, Mishev T, Georgiev M (2026) Contemporary surgical approaches for the closure of maxillary sinus defects with clinical cases from the authors’ practice. Journal of Biomedical and Clinical Research 19: 183-197. https://doi.org/10.3897/jbcr.e189851

Abstract

Maxillary sinus defects present a significant challenge in oral and maxillofacial surgery, particularly in cases associated with trauma, infection, or oncological resection. This article aims to provide a comprehensive overview of current surgical techniques for the closure of maxillary sinus defects and to highlight their clinical applicability through selected case presentations. Different reconstructive techniques are reviewed, including local and regional flaps, bone substitute materials combined with biomembranes, and microvascular composite flaps. Each approach has specific indications depending on defect characteristics and patient-related factors. The article includes clinical images from the archive of the surgeons at the Department of Otorhinolaryngology of Dr. Georgi Stranski University Hospital in Pleven. A satisfactory management of maxillary sinus defects requires an individualized approach and appropriate technique selection. Contemporary surgical methods offer reliable outcomes and contribute to improved patients’ quality of life.

Keywords

Biomaterial, bone substitutes, flaps, maxillary sinus, maxillary sinus defects, oroantral communications