Advances in Surgery for Chronic Rhinosinusitis
- 14 Downloads
Purpose of Review
Our understanding of chronic rhinosinusitis (CRS) is always evolving with new concepts and technological advancements in order to achieve the best surgical outcomes.
The extent of surgery has long been debated and current research has provided surgeons indications to create larger openings for the maxillary and frontal sinus. Historical concerns for larger openings impacting outcomes have been resolved with better understanding of post-operative management. Recent literature advocates the mega-antrostomy in the setting of cystic fibrosis or recalcitrant CRS despite previous standard FESS openings. Draf 3 is known to be used in cases of frontal sinus tumors, CSF leaks, mucoceles, and recalcitrant CRS to standard surgery. Technological advances have had impacted rhinology positively, with a number of in-office procedures becoming more common as well as new intra-operative tools to facilitate surgery. Moreover, post-operatively, the advent of a drug-eluting stent has fastened the healing process following FESS leading to better outcomes.
Advances in sinus surgery are always evolving. What may have been considered a poor approach in the past are being re-visited with better understanding of CRS and technological advancements.
KeywordsEndoscopic sinus surgery New advances Maxillary sinus antrostomy Frontal sinus surgery In-office procedures Image guidance
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no competing interests.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 10.•• Knisely A, Barham HP, Harvey RJ, Sacks R. Outside-In Frontal Drill-Out: How I Do It. AMERICAN JOURNAL OF RHINOLOGY & ALLERGY. 2015;29(5):397. This article provides a fast, safe and novel approach to recalcitrant,difficult to treat and challenging frontal sinus conditions. Google Scholar
- 11.Edur O, Ozturk K, Erkan K. Feasibility of a septal mucosal flap for preventing restenosis following the Draf III procedure. J Laryngol Otol. 2018;132(1)Google Scholar
- 16.Weiss, Raymond L; Church, Christopher A; Kuhn, Frederick A; Levine, Howard L; Sillers, Michael J; Vaughan, Winston CLong-term outcome analysis of balloon catheter sinusotomy: two-year follow-up. Otolaryngol Head Neck Surg 2008, 139:S38–S46.Google Scholar
- 20.Gan, Eng Cern; Habib, Al-Rahim R; Hathorn, Iain; Javer, Amin R. The efficacy and safety of an office-based polypectomy with a vacuum powered microdebrider: Vacuum-powered microdebrider. Int Forum Allerg Rhinology, 2013,3(11).Google Scholar
- 21.Coblation product brochure. Available at: https://www.smith-nephew.com/ global/assets/pdf/products/surgical/sportsmedicine/08427f%20multi-electrode %20technology%20brochure.pdf.
- 24.• Passali D, Loglisci M, Politi L, et al. Managing turbinate hypertrophy: coblation vs. radiofrequency treatment. Eur Arch Otorhinolaryngol 2016;273(6):1449–53. This article provides valuable data on the outcomes and efficacy of turbinates management using either coblation or radiofrequency ablation. Google Scholar
- 29.Akbari, E; Philpott, CM; Ostry, AJ; Clark, A; Javer, AR. A double-blind randomised controlled trial of gloved versus ungloved merocel middle meatal spacers for endoscopic sinus surgery. RHINOLOGY, 09/2012, Volume 50, Issue 3.Google Scholar