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Chapter-009 Endoscopic Sinus Surgery

BOOK TITLE: Head & Neck Surgery (2 Volumes)

Author
1. Braun Hannes
2. Stamm Aldo C
3. Pignatari Shirley SN
4. Lopes Hugo Canhete
5. Senior Brent A
6. Minovi Amir
7. Draf Wolfgang
8. Bockmühl Ulrike
9. Stammberger Heinz
10. Schick B
11. Bassim Marc
ISBN
9788184486797
DOI
10.5005/jp/books/10351_9
Edition
1/e
Publishing Year
2009
Pages
78
Author Affiliations
1. University Medical School Graz Auenbruggerplatz, Graz, Austria, University, Medical School, Graz, Austria
2. São Paulo ENT and Skull Base Center, at Edmundo Vaconcelos Hospital São Paulo-SP, Brazil; Federal University of São Paulo, São Paulo-SP, Brazil, Federal University of São Paulo, Brazil
3. Federal University of São Paulo; Hospital Professor Edmundo, Vasconcelos, São Paulo, Brazil, Federal University of São Paulo, Hospital Professor Edmundo Vasconcelos, São Paulo, Brazil
4. Hospital Professor Edmundo, Vasconcelos, São Paulo, Brazil
5. University of North Carolina at Chapel Hill, North Carolina, USA, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
6. Klinikum Fuldag AG, Teaching Hospital of the Philipps-University Marburg, Fulda, Germany
7. International Neuroscience Institute Hanover, Germany
8. Klinikum Fulda gAG, Teaching Hospital of the Philipps University Marburg, Fulda, Germany
9. University, Medical School, Graz, Austria
10. University Erlangen-Nürnberg, Germany
Chapter keywords
endoscopic sinus surgery, nasal endoscopy, computer tomography, paranasal sinuses, arterial hypotension, arterial vasodilators, Functional endoscopic sinus surgery, Acoustic rhinometry, sinonasal malignancies, nasal airway, non-invasive technique

Abstract

This chapter discusses endoscopic sinus surgery, where nasal endoscopy with rigid instruments and computer tomography (CT) of the paranasal sinuses enabled the surgeon to approach the osteomeatal complex (OMC) more precisely. Bleeding is a major concern during endonasal sinus surgery, where arterial hypotension will minimize hemodynamic causes for bleeding and, if required, can be achieved by intravenous administration of β-blockade or arterial vasodilators. Functional endoscopic sinus surgery (FESS) can be performed under general or local anesthesia depending on the patient’s condition, extent of disease and experience of the surgeon. The maxillary sinus ostium can usually be visualized after the uncinate process has been removed or after the frontal recess work. Acoustic rhinometry is a non-invasive technique to measure the cross-sectional area of regions of the nasal airway. Management of sinonasal malignancies requires at first an understanding of the pathology of skull-base lesions and the formulation of a treatment plan with a multidisciplinary oncological team.

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