The Prelacrimal Recess Approach: A Review of Surgical Applications, Outcomes, and Recent Advances

The prelacrimal recess approach (PLRA) has advanced endoscopic sinonasal surgery by providing improved access to the maxillary sinus and adjacent anatomical regions while preserving critical structures such as the inferior turbinate (IT) and nasolacrimal duct (NLD). First introduced in 2013, the PLR...

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Main Authors: Yeon Hee Im, Soo Whan Kim, Chan-Soon Park, Dong-Hyun Kim
Format: Article
Language:English
Published: Korean Rhinologic Society 2025-03-01
Series:Journal of Rhinology
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Online Access:http://j-rhinology.org/upload/pdf/jr-2024-00041.pdf
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author Yeon Hee Im
Soo Whan Kim
Chan-Soon Park
Dong-Hyun Kim
author_facet Yeon Hee Im
Soo Whan Kim
Chan-Soon Park
Dong-Hyun Kim
author_sort Yeon Hee Im
collection DOAJ
description The prelacrimal recess approach (PLRA) has advanced endoscopic sinonasal surgery by providing improved access to the maxillary sinus and adjacent anatomical regions while preserving critical structures such as the inferior turbinate (IT) and nasolacrimal duct (NLD). First introduced in 2013, the PLRA has become an important technique for addressing various sinonasal pathologies. This review comprehensively evaluates the advancements, applications, and outcomes associated with the PLRA. The PLRA enables superior visualization and access to regions that are traditionally difficult to reach with conventional techniques. Standardized surgical steps emphasize meticulous preservation of the NLD and IT, while technical modifications have broadened its feasibility in patients with narrow prelacrimal recesses. Applications of the PLRA span diverse pathologies, including sinonasal inverted papilloma, fungal infections, odontogenic cysts, and tumors of the lacrimal system, orbit, and skull base. Anatomical studies reveal significant variations in prelacrimal recess dimensions across populations, affecting surgical feasibility. Sex-specific differences, ethnic variations, and age-related factors are important in patient selection. Clinical outcomes from multiple investigations validate the PLRA’s efficacy in maintaining sinonasal function while achieving comprehensive lesion removal. Comparative analyses with traditional approaches underscore the PLRA’s advantages in reducing postoperative morbidity and recurrence rates. Integration of the PLRA with complementary surgical approaches further expands its therapeutic applications while maintaining favorable safety profiles. The PLRA is a safe and effective surgical method that offers favorable outcomes in disease management, symptom resolution, and anatomical preservation. With ongoing innovations and refinements, the PLRA is poised to remain a cornerstone of minimally invasive sinonasal surgery, enabling the precise and safe treatment of complex pathologies.
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spelling doaj-art-c3adb9cc0cf44e159a66b4b1e6a161b22025-08-20T02:32:14ZengKorean Rhinologic SocietyJournal of Rhinology1229-14982384-43612025-03-01321172710.18787/jr.2024.00041831The Prelacrimal Recess Approach: A Review of Surgical Applications, Outcomes, and Recent AdvancesYeon Hee Im0Soo Whan Kim1Chan-Soon Park2Dong-Hyun Kim3 Department of Otorhinolaryngology-Head and Neck Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Republic of Korea Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Department of Otorhinolaryngology-Head and Neck Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of KoreaThe prelacrimal recess approach (PLRA) has advanced endoscopic sinonasal surgery by providing improved access to the maxillary sinus and adjacent anatomical regions while preserving critical structures such as the inferior turbinate (IT) and nasolacrimal duct (NLD). First introduced in 2013, the PLRA has become an important technique for addressing various sinonasal pathologies. This review comprehensively evaluates the advancements, applications, and outcomes associated with the PLRA. The PLRA enables superior visualization and access to regions that are traditionally difficult to reach with conventional techniques. Standardized surgical steps emphasize meticulous preservation of the NLD and IT, while technical modifications have broadened its feasibility in patients with narrow prelacrimal recesses. Applications of the PLRA span diverse pathologies, including sinonasal inverted papilloma, fungal infections, odontogenic cysts, and tumors of the lacrimal system, orbit, and skull base. Anatomical studies reveal significant variations in prelacrimal recess dimensions across populations, affecting surgical feasibility. Sex-specific differences, ethnic variations, and age-related factors are important in patient selection. Clinical outcomes from multiple investigations validate the PLRA’s efficacy in maintaining sinonasal function while achieving comprehensive lesion removal. Comparative analyses with traditional approaches underscore the PLRA’s advantages in reducing postoperative morbidity and recurrence rates. Integration of the PLRA with complementary surgical approaches further expands its therapeutic applications while maintaining favorable safety profiles. The PLRA is a safe and effective surgical method that offers favorable outcomes in disease management, symptom resolution, and anatomical preservation. With ongoing innovations and refinements, the PLRA is poised to remain a cornerstone of minimally invasive sinonasal surgery, enabling the precise and safe treatment of complex pathologies.http://j-rhinology.org/upload/pdf/jr-2024-00041.pdfprelacrimal recess approachendoscopic sinus surgeryparanasal sinusesnasolacrimal duct
spellingShingle Yeon Hee Im
Soo Whan Kim
Chan-Soon Park
Dong-Hyun Kim
The Prelacrimal Recess Approach: A Review of Surgical Applications, Outcomes, and Recent Advances
Journal of Rhinology
prelacrimal recess approach
endoscopic sinus surgery
paranasal sinuses
nasolacrimal duct
title The Prelacrimal Recess Approach: A Review of Surgical Applications, Outcomes, and Recent Advances
title_full The Prelacrimal Recess Approach: A Review of Surgical Applications, Outcomes, and Recent Advances
title_fullStr The Prelacrimal Recess Approach: A Review of Surgical Applications, Outcomes, and Recent Advances
title_full_unstemmed The Prelacrimal Recess Approach: A Review of Surgical Applications, Outcomes, and Recent Advances
title_short The Prelacrimal Recess Approach: A Review of Surgical Applications, Outcomes, and Recent Advances
title_sort prelacrimal recess approach a review of surgical applications outcomes and recent advances
topic prelacrimal recess approach
endoscopic sinus surgery
paranasal sinuses
nasolacrimal duct
url http://j-rhinology.org/upload/pdf/jr-2024-00041.pdf
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