Surgical Treatment Of Sinusitis
The surgical treatment of sinusitis has seen a radical change in the recent past, and this is due to a better understanding of the physiology of sinuses and their functions. Endoscopic sinus surgery, as introduced in the USA in 1984, is based on the extensive clinical work performed by Professor Messerklinger and his associates from Graz, Austria. The technique is based on the endoscopic viewing of the surgical site at the time of surgery and can be carried out effectively under local anesthesia with sedation. General anesthesia is also used in performing this technique, a choice made by the surgeon in consultation with the patient. The procedure can be effectively performed with minimal bleeding and nasal packing is usually avoided. The type of endoscopic sinus surgery performed may vary significantly in patients, necessitating different forms of radiologic studies prior to the surgery. Computer-aided surgery has been in the forefront of endoscopic sinus surgery in the recent past and the triplanar viewing of the surgical site radiologically has provided the surgeon an opportunity to be clear about the usage of techniques at the surgical site. Patients who undergo endoscopic sinus surgery should be closely watched for wound healing in the post-operative period to obtain the desired results.
The surgical results and the improvement of symptoms are based on the disease condition, the wound healing process, and the diligent post-operative follow-up. The average duration for improvement of symptoms following surgery is usually three to four weeks, when the reepithelialisation is seen. The following images will describe the different steps of surgery in an uncomplicated endoscopic ethmoidectomy.
Surgical Technique
Tri-Planar images with probe in front of spenoid sinus and onodi cell.
