Combined functional endoscopic sinus surgery (FESS): a revisited approach

A technique of combined functional endoscopic sinus surgery (FESS) was carried out through the nose to clear up the ostiomeatal complex. A small window was then created in the canine fossa to remove the maxillary sinus pathology under endoscopic control. It aims at the complete removal of maxillary sinus pathology, which cannot be safely removed via the middle meatus while preserving the rest of the mucosa to ensure sinus rehabilitation. It also helps the surgeon in case of difficulty in locating the ostium during FESS. A series of 36 patients was studied over a period of two years, with a follow up, up to two years, post operatively. The present technique proved to be complementary to FESS with no serious complications. It is recommended for cases of recurrent antrochoanal polyps, oroantral fistula, sinusitis of dental origin or fungal infection of the nose and sinuses.