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[Endonasal microsurgery by Heermann++. Part II]
1Kliniki Laryngologicznej Szpitala Alfrieda Kruppa w Essen, Niemcy.
Abstract:
Endonasal sinus surgery in the case of inflammatory disease is of increasing importance. The maxillary, ethmoid, sphenoid and frontal sinus operations as well as the septumplasty are performed microsurgically. There are only few indications, when the intranasal procedure cannot be applied. We prefer all intranasal operations with the patient placed in semi-Fowler's position with hypotensive anaesthesia. Out of a total of 310 cases in which endonasal microsurgery was performed, 251 were submitted to a retrospective study 12-36 months after the operation. In our study there was an operative success rate of 92.8%. No complications such as: CSF leakage, persisting postoperative visual or ocular disturbance or vascular complications were observed. Compared with transfacial or external sinus surgery, the advantage of the transantral microsurgical technique are better functional results, fewer complications an a reduced duration of hospitalization.
Insights
Endonasal sinus surgery offers a high success rate for inflammatory sinus disease. This microsurgical approach results in better outcomes and fewer complications compared to external methods.
Area of Science:
- Otolaryngology and Rhinology
- Minimally Invasive Surgical Techniques
Background:
- Inflammatory sinus disease management increasingly utilizes endonasal surgical approaches.
- Microsurgical techniques are employed for maxillary, ethmoid, sphenoid, and frontal sinus operations, alongside septoplasty.
Discussion:
- The study retrospectively analyzed 251 endonasal microsurgeries performed on 310 patients, with follow-up ranging from 12 to 36 months.
- The preferred method involves semi-Fowler's position and hypotensive anesthesia for intranasal procedures.
- Transantral microsurgical techniques demonstrate advantages over transfacial or external sinus surgery, including improved functional results and reduced hospitalization.
Key Insights:
- An operative success rate of 92.8% was achieved in the studied cohort.
- No significant complications such as cerebrospinal fluid leakage, persistent visual or ocular disturbances, or vascular issues were reported.
- Endonasal microsurgery is a safe and effective treatment for chronic inflammatory sinus conditions.
Outlook:
- Further research can explore long-term outcomes and patient-reported quality of life.
- Continued refinement of microsurgical techniques may expand indications and improve patient selection.