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Functional Endoscopic
Sinus Surgery
BERNARD TAWFIK, MD ♦ IDEL MOISA, MD
Diplomates, American Board of Otolaryngology
Functional Endoscopic Sinus Surgery
Specializing in
Adult and Pediatric
Disorders of the
Ears, Nose, Throat and Neck
Functional Endoscopic Sinus Surgery, the standard
surgical treatment for chronic rhinosinusitis, is based on
the concept that the optimal way to re-establish normal,
healthy paranasal sinuses is to open their natural passages
into the nose. Once sinus drainage is improved, the
diseased sinus lining can regain its normal function of
cleaning the sinus cavity, and further infections tend to
subside.
Sinus Infections and Nasal Allergies
Endoscopic Sinus Surgery
Computer Image Guided Surgery
Balloon Sinuplasty
Sleep Apnea
Snoring
Head & Neck Surgery
Thyroid Gland
Parathyroid Glands
Salivary Glands
Oral Cavity
Larynx
Esophagus
Several technological advances have revolutionized sinus
surgery. In this update, we review Functional Endoscopic
Sinus Surgery, the most notable recent development in the
surgical treatment of chronic sinus infections.
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During Functional Endoscopic Sinus Surgery, thin
fiberoptic endoscopes with a variety of lenses allow a
thorough examination of the internal nose and sinus
openings. The use of micro-instruments under this
visualization makes possible the removal of abnormal
tissues from different regions of the nose and sinuses. All
of the paranasal sinuses may be accessed, including the
frontal, ethmoid, maxillary, and sphenoid sinuses.
Acid Reflux Disease
Pediatric ENT
Hearing and Balance
Voice and Swallowing
FEESST
Trans-Nasal Esophagoscopy
Laryngeal Video Stroboscopy
Affiliations
The extent of surgery depends on which sinus or sinuses
are affected, as well as various intranasal deformities
requiring correction. Common examples of intranasal
deformities contributing to sinus blockage include a
deviated nasal septum which may be surgically
straightened, enlarged middle turbinates (called concha
bullosa) which may be partly or completely removed, and
enlarged inferior turbinates which may be reduced in size
by a variety of techniques.
New York University School of Medicine
Glen Cove Hospital
Winthrop University Hospital
ProHealth Ambulatory Surgery Center
DayOp Center of Mineola
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Functional Endoscopic Sinus Surgery is performed
entirely through the nose, resulting in no facial scars,
little swelling and only mild discomfort. This surgical
approach is less extensive, and permits removal of
diseased tissue while keeping damage to surrounding
normal tissue to a minimum. Functional Endoscopic
Sinus Surgery is usually performed in an ambulatory
setting under general anesthesia, and patients usually
return to normal activities within a few days.
Functional Endoscopic
Sinus Surgery is based on
the physiologic principle
that the optimal way to reestablish normal, healthy
paranasal sinuses is to open
their natural passages into
the nose.
Indications for Surgery
Functional Endoscopic Sinus Surgery is indicated in individuals with a history of chronic
rhinosinusitis, appropriate findings on examination (through nasal endoscopy as described in our
previous article), and failure of optimal medical treatment. For surgical planning, a CT scan is
required to assess the extent of disease in each sinus, which sinuses need to be addressed
surgically, and what additional anatomic abnormalities need to be corrected. Only patients with
persistent sinus symptoms that have failed standard medical management should be considered
for surgery.
Summary
Functional Endoscopic Sinus Surgery, which is less invasive than older sinus operations, is
designed to enlarge the natural sinus openings into the nose, while leaving normal tissue
uninjured. Using specially designed instruments and fiberoptic endoscopes, different
obstructions to normal sinus drainage may be corrected. This surgical technique is associated
with less patient discomfort and less morbidity than the older, more invasive techniques for
treating inflammatory and infectious disorders of the paranasal sinuses. Functional Endoscopic
Sinus Surgery is indicated in individuals who have failed standard medical management, and in
whom appropriate clinical and CT scan findings are confirmed. This surgery is highly effective
in restoring normal function of the sinuses, relieving sinus symptoms, and decreasing recurrent
sinus infections. In general, this common surgery is safe, and well tolerated by patients.
This newsletter is provided in the interest of medical education and is not intended as medical advice.
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