S.50.273

The original version of the pediatric backbiter requires a 180° rotation after insertion of the instrument before engaging the uncinate process. The down-turn of the tip requires medial angulation of the shaft with use and makes it difficult to reach relatively lateral uncinates without impacting either the septum or the "anterior buttress ".
The up-turned version is inserted at the same angle as it is used and thus avoids the 180° rotation. It curves quite naturally around the buttress without impacting the anterior septum during use. It will reach the uncinate even with hypoplastic maxillary sinuses. In fact, it has not failed in over a thousand consecutive antrostomies.
Both versions were made available to the dozen ENT surgeons in our area at the same time. Given this objective choice without having "gotten used " to either version, every attending and even the residents universally preferred the up-turned modification (S.50.273).
The up-turned version, in summary, retains all of the advantages of the original, is easier to use, and fits the anatomy better.