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Uncinatotomy: performing endoscopic sinus surgery without an uncinectomy.

Haşmet Yazici1, Fatih Kemal Soy, Erkan Kulduk

  • 1From the *Balikesir University, Faculty of Medicine, Ear Nose Throat Clinic, Balikesir; †Mardin State Hospital, Ear Nose Throat Clinic, Mardin; ‡Adiyaman University, Faculty of Medicine, Ear Nose Throat Clinic, Balikesir; and §Bagcilar Medipol University, Faculty of Medicine, Ear Nose Throat Clinic, Istanbul, Turkey.

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Summary

This study introduces a novel endoscopic sinus surgery technique that preserves the uncinate process, successfully eradicating chronic rhinosinusitis pathology without complications in three patients.

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Area of Science:

  • Otolaryngology
  • Surgical Innovation

Background:

  • Endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) outcomes remain debated.
  • Current ESS techniques often involve uncinectomy, potentially disrupting normal anatomy and physiology.
  • A need exists for ESS methods that resolve disease while preserving sinonasal structures.

Purpose of the Study:

  • To present a novel ESS technique that avoids uncinate process excision.
  • To evaluate the efficacy and safety of this modified approach in treating sinonasal pathology.

Main Methods:

  • A new ESS technique was developed, focusing on medialization of the uncinate process with a bipedicle flap.
  • Pathology in isolated maxillary and anterior ethmoid cells was removed.
  • The uncinate process was repositioned at the completion of the surgery.

Main Results:

  • The technique successfully eradicated the primary sinonasal disease in all patients.
  • No intraoperative or postoperative complications were observed.
  • All three patients demonstrated positive outcomes following the procedure.

Conclusions:

  • This innovative ESS technique allows for complete sinus surgery without excising the uncinate process.
  • The method preserves anatomical structures, potentially improving surgical outcomes and sinonasal function.
  • This approach offers a viable alternative for CRS management, emphasizing tissue preservation.