Extended Endoscopic and Open Sinus Surgery for Refractory Chronic Rhinosinusitis

Otolaryngol Clin North Am. 2017 Feb;50(1):165-182. doi: 10.1016/j.otc.2016.08.013.

Abstract

This review discusses extended endoscopic and open sinus surgery for refractory chronic rhinosinusitis. Extended maxillary sinus surgery including endoscopic maxillary mega-antrostomy, endoscopic modified medial maxillectomy, and inferior meatal antrostomy are described. Total/complete ethmoidectomy with mucosal stripping (nasalization) is discussed. Extended endoscopic sphenoid sinus procedures as well as their indications and potential risks are reviewed. Extended endoscopic frontal sinus procedures, such the modified Lothrop procedure, are described. Extended open sinus surgical procedures, such as the Caldwell-Luc approach, frontal sinus trephine procedure, external frontoethmoidectomy, frontal sinus osteoplastic flap with or without obliteration, and cranialization, are discussed.

Keywords: Endoscopic modified medial maxillectomy; Endoscopic sinus surgery; Extended frontal sinusotomy; Extended maxillary antrostomy; Extended sphenoid sinusotomy; Modification of Lothrop procedure; Modified Lothrop procedure; Nasalization.

Publication types

  • Review

MeSH terms

  • Chronic Disease
  • Comparative Effectiveness Research
  • Humans
  • Nasal Surgical Procedures* / adverse effects
  • Nasal Surgical Procedures* / methods
  • Natural Orifice Endoscopic Surgery* / adverse effects
  • Natural Orifice Endoscopic Surgery* / methods
  • Paranasal Sinuses / surgery*
  • Recurrence
  • Rhinitis* / diagnosis
  • Rhinitis* / physiopathology
  • Rhinitis* / surgery
  • Sinusitis* / diagnosis
  • Sinusitis* / physiopathology
  • Sinusitis* / surgery