Extended Endoscopic and Open Sinus Surgery for Refractory Chronic Rhinosinusitis

Abstract

This review discusses extended endoscopic and open sinus surgery for refractory chronic rhinosinusitis. Extended maxillary sinus surgery including endoscopic maxillary mega-antrostomy, endoscopic modified medial maxillectomy, and inferior meatal antrostomy are described. Total/complete ethmoidectomy with mucosal stripping (nasalization) is discussed. Extended endoscopic sphenoid sinus procedures as well as their indications and potential risks are reviewed. Extended endoscopic frontal sinus procedures, such the modified Lothrop procedure, are described. Extended open sinus surgical procedures, such as the Caldwell-Luc approach, frontal sinus trephine procedure, external frontoethmoidectomy, frontal sinus osteoplastic flap with or without obliteration, and cranialization, are discussed.

Keywords: Endoscopic modified medial maxillectomy; Endoscopic sinus surgery; Extended frontal sinusotomy; Extended maxillary antrostomy; Extended sphenoid sinusotomy; Modification of Lothrop procedure; Modified Lothrop procedure; Nasalization.