Key Points 1. Endoscopic sinus surgical techniques have advanced to include the treatment of select orbital pathology due to the close proximity of the orbit to the paranasal sinuses, advances in surgical instrumentation, and a working relationship with ophthalmologists. 2.…
Key Points 1. Trauma is the most common cause of CSF leaks. 2. Endoscopic repair of CSF leaks is effective and offers decreased morbidity compared to open approaches. 3. Meticulous technique is key to success in repair of skull base…
Key Points 1. The goals of sinus surgery include atraumatic surgical technique, mucosal preservation, and restoration of normal sinus physiology. 2. The most common major complications of sinus surgery include hemorrhage, intracranial injury/cerebrospinal fluid (CSF) leak, and intraorbital injury. 3.…
Key Points 1. The various approaches to septoplasty include endonasal (Killian, hemitransfixion, transfixion incisions), open, endoscopic, and endoscopic-assisted. Many techniques exist for performing inferior turbinate reduction. Surgery on nondiseased middle turbinates is not commonly performed. 2. During septoplasty, care should…
Key Points 1. Chronic rhinosinusitis (CRS) in both adults and children is defined based on specific guidelines including both subjective and objective criteria. 2. CRS is a multifactorial inflammatory process characterized by a dysfunctional host–environment interaction. 3. Medical management of…
Key Points 1. Antibiotics are frequently administered to treat acute rhinosinusitis. Guidelines for appropriate antibiotic use should be followed. 2. Infectious complications of rhinosinusitis extending beyond the paranasal sinuses are rare. These include orbital, intracranial, and, less commonly osseous complications.…
Key Points 1. Allergic rhinitis can present with seasonal or perennial symptoms. 2. Beta 2- transferrin present on nasal discharge indicates cerebrospinal fluid (CSF) leak. 3. Rhinitis medicamentosa is associated with the use of over-the-counter intranasal decongestants that contain α-adrenergic…
Key Points 1. Anterior epistaxis is the most common and often originates from Little’s area in Kiesselbach’s plexus, whereas posterior bleeds commonly originate from the sphenopalatine artery distribution. 2. The most important initial evaluation is a rough gauge of epistaxis…
Key Points 1. While there can be great variation in sinus anatomy, the drainage patterns of the sinuses are fairly consistent. 2. Embryologic patterns of pneumatization of the paranasal sinus lamellae aid in understanding of related anatomy. 3. The blood…
Key Points 1. Radiation therapy (RT) uses ionizing radiation to locally treat cancers, while systemic therapy uses cytotoxic chemotherapy or molecular targeted biologics to systemically treat cancers. 2. Compared to surgical treatment of head and neck (HN) cancers, radiation potentially…