FESS Technique

Abstract

The two classic endoscopic approaches are those of Messerklinger (1985) and Wigand (1978). The Wigand technique calls for a back-to-front exenteration of disease from the paranasal sinuses, while the Messerklinger approach deals with the anterior group of sinuses unless there is definite evidence of posterior group disease in which case a complete fronto-ethmoido-sphenoidotomy and frontal sinusotomy could be performed. Both aim at re-establishing normal drainage channels, thereby reversing the diseased mucosa to normalcy; — the latter technique, however, is more widely practised the world over. We have based our technique on that of Messerklinger, as a vast majority of our patients present with early disease. The Wigand technique finds application in cases of massive polyposis or in revision surgery (where anatomical landmarks are distorted).