A comparative study of two different uncinectomy techniques: swing-door and classical.

Area of Science:

• Otolaryngology
• Surgical Techniques
• Rhinology

Background:

• Functional Endoscopic Sinus Surgery (FESS) is a common procedure for sinusitis.
• Uncinectomy is a key step in FESS, with classical and swing door techniques being compared.
• Patient selection involved those with persistent sinusitis after medical management, confirmed by CT scans.

Purpose of the Study:

• To compare the outcomes of classical uncinectomy versus the swing door technique in Functional Endoscopic Sinus Surgery (FESS).
• To evaluate the complication rates associated with each uncinectomy technique.

Main Methods:

• A comparative study involving 480 patients with sinusitis undergoing FESS.
• 240 patients underwent classical uncinectomy, while 240 underwent the swing door technique.
• Outcomes were assessed based on complication incidence, including ethmoidal complex injury, incomplete removal, and orbital or lacrimal duct injuries.

Main Results:

• The classical technique in 240 uncinectomies resulted in 4 ethmoidal complex injuries, 12 cases of incomplete removal, and 5 orbital fat exposures.
• The swing door technique in 240 uncinectomies led to 2 cases of incomplete removal and 3 lacrimal duct injuries.
• The swing door technique demonstrated a significantly lower incidence of orbital penetration, incomplete removal, ethmoidal complex injury, and ostium non-identification compared to the classical technique.

Conclusions:

• The swing door technique is recommended for uncinectomy in FESS.
• This technique is easier to learn and facilitates complete uncinate removal.
• It allows for straightforward identification of the maxillary sinus natural ostium without ethmoidal complex injury.