Caldwell-Luc may be performed under local or general anesthesia depending on the patient’s
preference, the surgeon’s experience, the health and age of the patient, and the complexity of the
proposed procedure. Local anesthetic with epinephrine should be injected into the soft tissue over the
maxillary sinus and the common wall of this sinus and the nose. Several minutes should be allowed to
lapse before beginning surgery to permit good anesthesia and vasoconstriction of blood vessels.
For patient comfort, this procedure typically is performed under general
anesthesia. However, if medical comorbidities preclude general anesthesia,
the procedure may be performed with local anesthetic and sedation. It may be
performed in conjunction with nasoantral window (inferior antrostomy) to
facilitate postoperative surveillance.
Lidocaine, 1% with 1:100,000 epinephrine, is injected in the incision site, and
time is allowed for vasoconstriction. Make a 3-cm incision centered over the
canine tooth and first premolar while leaving about 0.5-1 cm of gingiva intact
above the dentition to facilitate closure.

Position: Sitting or supine

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