Endoscopic Sinus Surgery

2021 ◽  
Author(s):  
Chetan Safi ◽  
David A. Gudis ◽  
Aaron Oswald

Endoscopic sinus surgery has revolutionized the field of otolaryngology and is now the surgical standard of care in treating most paranasal sinus disorders. A graduating otolaryngology resident must be proficient in performing endoscopic sinus surgery (ESS) to care for common sinonasal pathology. Thus, our goal with this chapter is to provide a systematic guide of ESS for surgeons at all stages of training. We discuss the indications for ESS, the thorough review of preoperative computed tomography, the intraoperative technique for ESS, as well as complications. We believe that careful review of this chapter will provide physicians with a comprehensive base to understand the concept of endoscopic sinus surgery and will allow them to develop their technique and skills as they continue to train. This review contains 5 figures, 5 tables, 34 references Keywords: Endoscopic Sinus Surgery, Surgical Education, Surgical Technique, Surgical Complications, Open Sinus Surgery Approaches

2021 ◽  
Author(s):  
Chetan Safi ◽  
David A. Gudis ◽  
Aaron Oswald

Endoscopic sinus surgery has revolutionized the field of otolaryngology and is now the surgical standard of care in treating most paranasal sinus disorders. A graduating otolaryngology resident must be proficient in performing endoscopic sinus surgery (ESS) to care for common sinonasal pathology. Thus, our goal with this chapter is to provide a systematic guide of ESS for surgeons at all stages of training. We discuss the indications for ESS, the thorough review of preoperative computed tomography, the intraoperative technique for ESS, as well as complications. We believe that careful review of this chapter will provide physicians with a comprehensive base to understand the concept of endoscopic sinus surgery and will allow them to develop their technique and skills as they continue to train. This review contains 5 figures, 5 tables, 34 references Keywords: Endoscopic Sinus Surgery, Surgical Education, Surgical Technique, Surgical Complications, Open Sinus Surgery Approaches


Author(s):  
Sumit Prinja ◽  
Jailal Davessar ◽  
Gurbax Singh ◽  
Simmi Jindal ◽  
Alisha Bali

<p class="abstract">Anatomic variations of the paranasal sinuses can lead to various diseases per se. The paranasal sinus anatomy should be carefully examined prior to performing endoscopic sinus surgery in terms of both existent pathologies and anatomic variations. The anatomy of the paranasal sinuses and its variations have gained importance, along with advances in coronal paranasal sinus computed tomography and extensive use of endoscopic sinus surgery. Rhinolith is a mass resulting from calcification of an endogenous or exogenous nidus within the nasal cavity. It is an uncommon disease that may present asymptomatically or cause symptoms like headache and nasal obstruction. A 24 year old woman was admitted in ENT department of GGS Medical College and Hospital, Faridkot with complaints of nasal obstruction, anosmia and headache persisting for 5 years. Right sided rhinolith was detected on anterior rhinoscopy. Bilateral concha bullosa with right sided rhinolith was reported on preoperative paranasal computed tomography scan. It is known that the paranasal sinuses have a number of anatomical variations. Sometimes severe anatomic variations predispose to rhinosinusitis. Herein we report a rare case, along with a review of the literature, to emphasize that severe anatomical variations should not be ignored.</p>


2016 ◽  
Vol 9 (1) ◽  
pp. 1-5
Author(s):  
Kiran Rao

ABSTRACT A prospective study was conducted on 50 patients at the SGRD Institute of Medical Sciences and Research, Amritsar, suffering from paranasal sinus disease correlating the findings of computed tomography (CT) using Siemens SOMATOM Emotion 6 slice CT machine with diagnostic nasal endoscopy or functional endoscopic sinus surgery (FESS). Infection of the paranasal sinuses is very common. Surgical clearance of these chronically infected sinuses while maintaining their ventilation and drainage is the treatment of choice. To achieve this goal, there should be some diagnostic modality that guides us toward the exact diagnosis and safe intervention. Computed tomography proves to be the most reliable method of preoperative assessment of patients undergoing FESS as it delineates the extent of the disease and defines any anatomical variants and relationship of the sinuses with the surrounding important structures, thus providing a road map for sinus surgery. In our study, most patients were in the 3rd and 4th decades of their life with equal disease incidence in males and females. The most common sinus involved was anterior ethmoid sinus, while sphenoid sinus was the least commonly involved. The most common pattern of inflammation was sinonasal polyposis followed by osteomeatal unit pattern. On correlating CT diagnosis with the final diagnosis, chronic sinusitis had 86% sensitivity and 96.5% specificity. Polyps had sensitivity of 96.15% and specificity of 95.83%. Again for fungal sinusitis, CT had a lower sensitivity of 71.4% and specificity of 93.02%. For diagnosing benign and malignant lesions, CT had 100% sensitivity and specificity, which could be due to the small number of masses evaluated. This study proved that CT is the modality of choice for evaluating and planning the management of symptomatic patients of paranasal sinus pathologies. How to cite this article Rao K. Computed Tomography of Paranasal Sinus Pathologies with Functional Endoscopic Sinus Surgery/Nasal Endoscopy Correlation. Clin Rhinol An Int J 2016;9(1):1-5.


2015 ◽  
Vol 8 (1) ◽  
pp. 15-19
Author(s):  
Kiran Rao

ABSTRACT A prospective study conducted on 50 patients in Sri Guru Ram Das (SGRD) Institute of Medical Sciences and Research, Amritsar, India, suffering from paranasal sinus diseases correlating the findings of computed tomography (CT) using Siemens somatom emotion 6 slice CT machine with diagnostic nasal endoscopy or functional endoscopic sinus surgery (FESS). Infection of the paranasal sinuses is very common. Surgical clearance of these chronically infected sinuses while maintaining their ventilation and drainage is the treatment of choice. To achieve this goal, there should be some diagnostic modality which guides us towards exact diagnosis and safe intervention. Computed tomography proves to be the most reliable method of preoperative assessment of patients undergoing FESS as it delineates the extent of the disease, define any anatomical variants and relationship of the sinuses with the surrounding important structures. Thus, providing a road map for sinus surgery. In our study, most patients were in the 3rd and 4th decades of their life with equal disease incidence in males and females. The most common sinus involved was anterior ethmoid sinus while sphenoid sinus was least commonly involved. Commonest pattern of inflammation was sinonasal polyposis followed by osteomeatal unit pattern. On correlating CT diagnosis with final diagnosis, chronic sinusitis has 86% sensitivity and 96.5% specificity. Polyps have sensitivity of 96.15% and specificity of 95.83%. Again for fungal sinusitis CT has lower sensitivity of 71.4% and specificity of 93.02%. For diagnosing benign and malignant lesions CT has 100% sensitivity, specificity, could be due to small number of masses evaluated. This study proved that CT is the modality of choice for evaluation and planning the management of symptomatic patients of paranasal sinus pathologies. How to cite this article Rao K. Computed Tomography of Paranasal Sinus Pathologies with Functional Endoscopic Sinus Surgery/Nasal Endoscopy Correlation. Clin Rhinol An Int J 2015;8(1):15-19.


2013 ◽  
Vol 127 (9) ◽  
pp. 872-875 ◽  
Author(s):  
H Jung ◽  
S K Park

AbstractObjective:To report the clinical characteristics and treatment outcomes of indolent paranasal mucormycosis in immunocompetent individuals.Materials and methods:A retrospective review of four immunocompetent patients with indolent mucormycosis of the paranasal sinus managed by endoscopic sinus surgery only was performed. One year of regular follow up comprised angled endoscopy and repeated paranasal sinus computed tomography three months after surgery.Results:Clinical symptoms were non-specific. Pre-operative paranasal sinus computed tomography showed opacification of the unilateral maxillary sinus with focal calcification but without bony destruction or extension to the orbit or cranium. All patients underwent endoscopic sinus surgery without administration of antifungal agents. There was no recurrence on regular clinical and radiological follow up.Conclusion:For indolent paranasal mucormycosis in immunocompetent patients, endoscopic sinus surgery can be the treatment of choice, and the administration of antifungal drugs may not be necessary.


1993 ◽  
Vol 7 (5) ◽  
pp. 213-216 ◽  
Author(s):  
Donald C. Lanza ◽  
Deborah Farb Rosin ◽  
David W. Kennedy

A variety of surgical approaches exists for the management of nasal septal spurs in patients who undergo endoscopic sinus surgery (ESS). Treatment of septal spurs in the past has been frequently addressed by septoplasty which can result in increased bleeding and length of surgical procedure as well as mandate postoperative nasal packing. Individually each of these problems can jeopardize the success of endoscopic sinus surgery. An endoscopic approach, which targets the septal spur alone, can minimize perioperative morbidity. The purpose of this paper is to demonstrate the effectiveness of endoscopic septal spur resection (ESSR) for the management of significant septal spurs in 8 patients who underwent concurrent ESSR during ESS for chronic sinusitis. Surgical technique and postoperative results are discussed and suggest that ESSR is a valuable alternative to more traditional techniques.


2019 ◽  
Vol 99 (6) ◽  
pp. 384-387 ◽  
Author(s):  
Omar H. Ahmed ◽  
Marissa P. Lafer ◽  
Ilana Bandler ◽  
Elcin Zan ◽  
Binhuan Wang ◽  
...  

Objectives: To examine the frequency in which angled endoscopes are necessary to visualize the true maxillary ostium (TMO) following uncinectomy and prior to maxillary antrostomy. Additionally, to identify preoperative computed tomography (CT) measures that predict need for an angled endoscope to visualize the TMO. Study Design: Retrospective study. Setting: Tertiary academic hospital. Patients and Methods: Patients who underwent endoscopic sinus surgery (ESS) between December of 2017 and August of 2018 were retrospectively identified. Cases were reviewed if they were primary ESS cases for chronic rhinosinusitis without polyposis and if they were at least 18 years of age. Results: Sixty-three maxillary antrostomies were reviewed (82.5% were from bilateral cases). Thirty-five cases (55.6%) required an angled endoscope in order to visualize the TMO. Of the preoperative CT measures examined, a smaller sphenoid keel-caudal septum-nasolacrimal duct (SK-CS-NL) angle was significantly associated with need for an angled endoscope intraoperatively to visualize the TMO (17.1° SD ± 3.2 vs 15.0° SD ± 2.9; P = .010). Conclusion: Angled endoscopes are likely required in the majority of maxillary antrostomies to visualize the TMO. This is important to recognize in order to prevent iatrogenic recirculation. The SK-CS-NL angle may help to identify cases preoperatively which require an angled endoscope to identify the TMO during surgery.


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