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Updated: Jul 15, 2026

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Progress in surgical management of chronic rhinosinusitis and nasal polyposis
1Harvard Medical School, Division of Otolaryngology, Brigham and Women's Hospital, 45 Francis Street, Boston, MA 02115, USA. neiloy@massmed.org
Abstract:
Endoscopic sinus surgery (ESS) remains the treatment of choice for medically refractory chronic rhinosinusitis (CRS) with or without nasal polyposis (NP). ESS has undergone review, reassessment, and substantial refinement. Several advances (eg, powered instrumentation, image guidance, adjunctive intraoperative procedures) have expanded the scope of cases amenable to ESS, decreased operative time and intraoperative blood loss, and improved safety. Procoagulant nasal/sinus packing and refinements of technique have decreased the need for postoperative removal of packing, thus decreasing morbidity. Methods to reduce synechia formation (ie, mitomycin-c) have been explored, with mixed results. Novel methods of sinusotomy (eg, balloon catheter dilatation of the sinus ostia) have had limited but interesting short-term results. We can expect further advances in ESS with better patient outcomes. However, continued elucidation of the underlying pathophysiology of CRS and NP are essential to long-term improvement.
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