Treatment of sinus and nasal disorders in the 21st century

In the modern history of the surgical treatment of sinus and nasal problems, there have been three revolutionary changes. The first was the introduction and refinement of endoscopic techniques in the 1980s. The second important development in the modern history of rhinology was the introduction of powered instrumentation in the 1990s. Now in the 21st Century we see a third turning point, which is the use of intraoperative image guidance in endoscopic sinus surgery. These three advances are being integrated to provide a new level of care for problems of the nose and sinuses and are the subject of this special section. In the first articles, the author provides an overview of sinusitis and reviews many of the medical treatments available for the management of sinusitis. When anatomic abnormalities of the nose and sinuses contribute to sinusitis, and when medical therapy has failed, these anatomic or structural abnormalities can be surgically corrected. In the article entitled "Minimally Invasive Approach to Endoscopic Sinus Surgery," we review this modern approach to the sinuses and discuss recent advances. We also provide an overview of rhinoplasty--surgery to reshape the nose--with special emphasis on the surgical anatomy and preoperative analysis of appearance. We conclude by reviewing some of the more common adjunctive cosmetic procedures performed with surgery of the nose and sinuses.