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Surgical Treatment of Sinusitis

Content provided by Steven Schaefer, M.D.
Department of Otolaryngology/Head and Neck Surgery
The New York Eye and Ear Infirmary of Mount Sinai

The origin of sinus surgery is unknown. The Edwin Smith Papyrus (700B.C.) describes evacuation of subdural hemorrhage via trephination of the skull. It is quite possible that trephination was also employed by the ancient Egyptian to treat serious sinus infections.

Millennia would pass before formal surgical procedures were described for the treatment of sinusitis. In the twentieth century, sinus surgery has evolved from primarily external or open to intranasal approaches (e.g., through the nose) to the sinuses. The advent of optical telescopes or endoscopes provided both illumination and magnification within the nose and sinuses to permit an evolution in surgical principles.

Building upon the physiologic studies of Messerklinger, a minimally invasive approach which encompassed the maximal preservation of normal sinus anatomy was introduced in the United States in the 1980’s as functional endoscopic sinus surgery (FESS).

As FESS is a concept, and not an actual surgical procedure, defined operations on each of the sinuses are performed utilizing minimally invasive techniques. Among such procedures are:

Ethmoidectomy
Antrostomy
Sphenoidotomy
Frontal Sinusotomy

Additional sinus surgeries include:

Caldwel Luc
Osteoplastic Frontal Sinusotomy
Orbital Decompression for Thyroid Eye Disease
Optic Nerve Decompression
Closure of Cerebral Spinal Fluid Fistulas to the Nose
Cranial Facial Tumor Surgery

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References

Kennedy, D. 1985 Functional endoscopic sinus surgery. Technique. Arch. Otolaryngol., 111:576-582.

Messerklinger, W. 1985 Endosckopiche diagnose und chirugie der rezidivierenden sinusitis. In: Krajina, Z., ed. Advances in Nose and Sinus Surgery. Zagreb, Yugoslavia: Zagreb University. 

Schaefer, S.D. 1998 An anatomic approach to endoscopic intranasal ethmoidectomy. Laryngoscope, 108:1628-1634.

Stammberger, H. 1986 Endoscopic endonasal surgery-concepts in the treatment of recurring rhinosinusitis: Part II. Surgical technique. Otolaryngol. Head Neck Surg., 94:147-156.

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Learn More About Rhinology & the Sinuses

General Description of Sinusitis

What is Sinusitis?

Medical Treatment of Sinusitis

Antibacterials, antifungals, and nasal steroids

Surgical Treatment of Sinusitis:

 

Definition

 

What to Expect When Undergoing Sinus Surgery

 

Ethmoidectomy & Antrostomy

 

Sphenoidotomy

 

Frontal Sinusotomy

 

Caldwell Luc

 

Orbital & Optic Nerve Decompression

 

CSF Rhinorrhea

 

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