In a recently published review of the current understanding and study-based directives on reducing CAUTI, Tambyah and Oon (2012) state that "all guidelines agree that ensuring dependent drainage
significantly reduced the risk of CAUTI (the drainage tubing should be below the level of the patient's bladder but above the level of the collection bag)" (p.
Described in 1880 by Mikulicz, an inferior meatal antrostomy was a commonly performed sinus procedure for maxillary sinus disease, (5,6) The rationale for performing this procedure was that dependent drainage
of secretions would be expected.
A large, prospective study monitored compliance on a daily basis with seven recommended precepts for catheter care, including closed drainage, dependent drainage
including proper position of the drainage tubing and collection bag, and protection of the drainage port; the only violation predictive of an increased risk of CAUTI was improper position of the drainage tube, above the level of the bladder or sagging below the level of the collection bag (RR 1.9) (27).
(2010) recommend ensuring dependent drainage
as appropriate management of Foley drainage systems.
through an inferior antrostomy may benefit patients with disturbed mucociliary transport--for example, patients with cystic fibrosis or those who have undergone mucosal stripping during a Caldwell-Luc procedure.
Because the inferior meatal antrostomy is performed today for dependent drainage
, the window should be large and its lower border should be at the same level as or close to the floor of the nasal cavity.