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This picture shows important anatomy involved in endoscopic endonasal surgery. The pituitary gland sits at the top of the picture behind the sphenoid sinus. This approach is the most common and useful technique of endoscopic endonasal surgery and was first described in 1910 concurrently by Harvey Cushing and Oskar Hirsch.
Functional endoscopic sinus surgery (FESS) is a procedure that is used to treat sinusitis and other conditions that affect the sinuses.Sinusitis is an inflammation of the sinuses that can cause symptoms such as congestion, headaches, and difficulty breathing through the nose.
Nasal surgery is a specialty including the removal of nasal obstruction that cannot be achieved by medication and nasal reconstruction. Currently, it comprises four approaches, namely rhinoplasty, septoplasty, sinus surgery, and turbinoplasty, targeted at different sections of the nasal cavity in the order of their external to internal positions.
Sinus surgery with balloons may be performed in a hospital, outpatient surgery setting or in the physician’s office under local anesthesia. The physician inserts a guide catheter through the nostril and near the sinus opening under endoscopic visualization. A flexible guide wire is then introduced into the targeted sinus to confirm access.
Most surgeries are completed in 60 minutes or less, while the recovery time could be up to several weeks. Put simply, septoplasty is a surgery that helps repair the passageways in the nose making it easier to breathe. This surgery is usually performed on patients with a deviated septum, recurrent rhinitis, or sinus issues.
Caldwell-Luc surgery, Caldwell-Luc operation, also known as Caldwell-Luc antrostomy, and Radical antrostomy, is an operation to remove irreversibly damaged mucosa of the maxillary sinus. It is done when maxillary sinusitis is not cured by medication or other non-invasive technique. The approach is mainly from the anterior wall of the maxilla bone.
With the advent of nasal endoscopes, endoscopic dacryocystorhinostomy is becoming popular. In this procedure, a nasal endoscope is used to visualise the lacrimal sac through the nasal cavity. The bone covering the lacrimal sac is nibbled out. The medial wall of the sac is incised or excised, facilitating drainage of tears into the nasal cavity.
If more than three successive puncture shows returning fluid to be persistently purulent, the patient may require functional endoscopic sinus surgery (FESS) and occasionally may need Caldwell-Luc operation. [4] As antral Washout is a much simpler procedure compared to FESS, it may be done on an outpatient basis for Subacute Maxillary Sinusitis.