Introduction ▪ The modified medial maxillectomy entails removing a large portion of the medial maxillary wall to gain wide access to the maxillary sinus. It is primarily used for the removal of benign tumors, such as inverted papillomas and juvenile…
Introduction ▪ Completion sphenoethmoidectomy refers to a revision sinus procedure in a patient in whom a maxillary antrostomy and partial ethmoidectomy have been previously performed. ▪ Patients with nasal polyposis and moderate to severe inflammatory disease commonly have persistent symptoms…
Introduction ▪ Balloon sinus dilatation is a surgical technique that widens the natural sinus ostium using a balloon catheter. ▪ Balloon sinus dilatation has been used to address the maxillary, sphenoid, and frontal sinuses. It can be performed as a…
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…
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…
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…
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. ▪…
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…
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…
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…