Extended Endoscopic and Open Sinus Surgery for Refractory Chronic Rhinosinusitis

Area of Science:

• Otolaryngology
• Surgical Innovation

Background:

• Chronic rhinosinusitis (CRS) can be refractory to medical management.
• Surgical interventions are crucial for managing severe and persistent CRS.
• Advanced techniques offer alternatives for complex sinonasal pathologies.

Purpose of the Study:

• To review extended endoscopic and open sinus surgical procedures for refractory chronic rhinosinusitis.
• To describe specific surgical techniques and their applications.
• To discuss indications and potential risks associated with these advanced procedures.

Main Methods:

• Review of extended endoscopic sinus surgery techniques, including maxillary mega-antrostomy, modified medial maxillectomy, complete ethmoidectomy, and advanced sphenoid and frontal sinus procedures (e.g., modified Lothrop).
• Discussion of extended open sinus surgery approaches, such as Caldwell-Luc, frontal trephine, external frontoethmoidectomy, osteoplastic flap, and cranialization.
• Synthesis of current literature on surgical management for refractory CRS.

Main Results:

• Detailed descriptions of various extended endoscopic procedures for maxillary, ethmoid, sphenoid, and frontal sinuses.
• Comprehensive overview of open sinus surgical techniques for challenging cases.
• Exploration of indications, risks, and potential benefits of these advanced surgical options.

Conclusions:

• Extended endoscopic and open sinus surgeries represent valuable options for refractory chronic rhinosinusitis.
• These advanced techniques require specialized knowledge and careful patient selection.
• Further research may elucidate optimal indications and outcomes for specific procedures.