Atlas of Endoscopic Sinus and Skull Base Surgery

Postoperative Débridement

Introduction ▪ For many, postoperative débridement is considered a crucial aspect of optimizing endoscopic surgical results. ▪ The most widely cited study supporting the practice of postoperative débridement is that of Senior et al., which suggested that weekly postoperative débridement was…

Frontal Sinusotomy—Draf III

Endoscopic Common Frontal Sinusotomy Introduction ▪ The common frontal sinusotomy, modified endoscopic Lothrop procedure (MELP), or Draf III procedure, is an adaptation of the technique first described by Dr. Harold Lothrop in 1914. Wolfgang Draf popularized the operation in the…

Frontal Sinusotomy—Draf IIb

Introduction ▪ Endoscopic sinus and skull base surgery has become an effective part of the management of chronic rhinosinusitis (CRS) and tumors of the sinuses and anterior skull base. Technologic advances have been critical in advancing endoscopic surgical procedures, with…

Frontal Sinusotomy—Draf I and IIa

Introduction ▪ Dissection of the frontal recess is the most difficult of the basic endoscopic dissections. ▪ Care must be taken to preserve the mucosa surrounding the frontal recess. Stripping of mucosa can result in postoperative stenosis and neo-osteogenesis. ▪…

Sphenoidotomy

Introduction ▪ There are two ways to approach and perform a sphenoidotomy: transnasal and transethmoid. ▪ In the transnasal approach, the sphenoidotomy is performed while sparing the ethmoid cavity. Dissection proceeds medial to the middle turbinate. Common indications for this…

Partial and Complete Ethmoidectomy

Introduction ▪ The terms partial and complete ethmoidectomy refer to the removal of the anterior and posterior ethmoids ( Figs. 7.1 and 7.2 , respectively). ▪ A partial ethmoidectomy is the removal of the ethmoid bulla and any cells against…

Maxillary Antrostomy

Introduction ▪ The maxillary antrostomy is the first step in performing functional endoscopic sinus surgery. ▪ Based on a good working knowledge of the anatomy and using proper visualization and mucosa-sparing techniques, a well-performed maxillary antrostomy will not only address…

Endoscopic Repair of Choanal Atresia

Introduction The opening of choanal atretic plates can be obtained by various techniques. Despite the substantial available published literature on the treatment modalities of choanal atresia, the optimum technique is not fully established. The choice many times depends on the…