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© 2015, Jaypee Brothers Medical Publishers

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First Edition: 2015

Printed at

Endoscopic sinus surgery was introduced in India in 1986. Dr Milind Kirtane was one of the pioneers who started with this technique in King Edward Memorial Hospital, Mumbai, Maharashtra, India. This surgery was initially meant for chronic sinusitis refractory to medical treatment. The last three decades have seen a tremendous expansion in its indications. The nasal endoscopist now operates not only in the nose and sinuses but accesses also the surrounding areas such as the orbit, the infratemporal fossa and cranial cavity. Sophistication in instrumentation, advances in imaging techniques and introduction of intraoperative navigation have made this possible and relatively safe. Lesions of the skull base which were difficult to access can now be tackled under direct vision thanks to the endoscope.

Functional endoscopic sinus surgery (FESS) was introduced as a treatment for intractable chronic sinusitis, which failed to respond to medical management. The concept was to re-establish the drainage and aeration of the paranasal sinuses so that the underlying mucosa, which was inflamed, could heal. Surgeons found that they could go beyond the scope of this indication and started operating on different conditions, including tumors within the nose and paranasal sinuses, and then expanded to the surrounding areas such as the orbit and the skull base.