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Chapter-021 Minimally Invasive Sinus Surgery

BOOK TITLE: Head & Neck Surgery (2 Volumes)

Author
1. Catalano Peter J
ISBN
9788184486797
DOI
10.5005/jp/books/10351_21
Edition
1/e
Publishing Year
2009
Pages
6
Author Affiliations
1. Tufts University; St. Elizabeth Medical Center, Boston, Massachusetts, USA, Boston University Boston Massachusetts, USA
Chapter keywords
minimally invasive sinus technique, MIST, functional endoscopic sinus surgery, pathophysiologic mechanisms, sinusitis, edema, laryngeal mask technique, LMA, middle meatal antrostomy, antral mass, biopsy, maxillary sinus fungal ball, maxillary recirculation

Abstract

This chapter discusses minimally invasive sinus surgery, where functional endoscopic sinus surgery (FESS) was the first surgical model for sinus intervention to address the underlying pathophysiologic mechanisms of sinusitis. The minimally invasive sinus technique (MIST) is a targeted endoscopic intervention with virtually identical goals to those originally reported for FESS. Routine resection of the middle turbinate often leads to edema or stenosis of the nasofrontal duct, and can produce compensatory glandular hypertrophy of the remaining nasal tissue. Creation of a middle meatal antrostomy (MMA) is occasionally required, where absolute indications include the biopsy of an antral mass, presence of one or more accessory ostia leading to maxillary recirculation, resection of a maxillary sinus fungal ball or inverted papilloma, and to allow for the application of topical medications or repeated antral lavage in select cases. Anesthesia is achieved with general anesthesia, preferentially via a laryngeal mask technique (LMA).

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