[Minimally invasive surgery of the paranasal sinuses]

Surgery of the paranasal sinuses for chronic sinusitis or nasal polyposis has changed profoundly over the last decades. Today, minimally invasive surgery through the nostrils is the standard of care throughout the world. Classic procedures using an extranasal approach have been abandoned almost completely. This development was mainly driven by the introduction of rigid telescopes providing an angled view of the operation field. In addition, new pathophysiological findings have suggested less radical procedures. Functional endoscopic sinus surgery (FESS) shows high success rates, complications are rare, but potentially serious. Computer-assisted surgery systems for intraoperative navigation are at the threshold of being used on a routine basis. However, at the present time their use must not be considered as mandatory for the vast majority of cases. Postsurgical treatment using nasal irrigations with normal saline solution and topical application of steroids is of great importance to provide long-term success following surgical interventions.