Microscopic sinus surgery, transnasal ethmoidectomy and sphenoidectomy.

Area of Science:

• Otolaryngology
• Surgical Innovation

Background:

• Traditional intranasal ethmoid surgery relies on monocular vision, limiting instrument control and potentially increasing complication risks.
• The procedure has historically been considered a
• blind procedure
• due to limited visualization.

Purpose of the Study:

• To evaluate the safety and efficacy of incorporating an operating microscope and specialized retractor for intranasal ethmoid surgery.
• To assess the impact of binocular vision and improved instrument control on surgical outcomes and complication rates.

Main Methods:

• A series of 87 patients undergoing intranasal ethmoid surgery over 7 years, with 49 having transethmo-sphenoidectomy.
• Utilized an operating microscope with a self-retaining retractor speculum to enhance visualization and instrument manipulation.
• Reviewed anatomical considerations, surgical technique, and patient outcomes.

Main Results:

• No serious complications were reported in this series of 87 patients, contrasting with a reported 3% rate in other large studies.
• The technique demonstrated improved surgeon confidence due to binocular vision and enhanced instrument control.
• Successful outcomes were also noted in 181 microscopic antrostomies performed using this approach.

Conclusions:

• The addition of an operating microscope significantly enhances the safety of intranasal ethmoid surgery.
• This technique provides surgeons with greater confidence and instrument control, leading to more adequate and safer procedures.
• Microscopic visualization minimizes the fear of dreaded complications, improving patient safety and surgical results.