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Functional Endoscopic Sinus Surgery (FESS) - Part 2

In the first of this two-part series, Martyn Barnes and colleagues discussed indications for functional endoscopic sinus surgery (FESS), the surgical objectives and techniques, patient expectations and the risks of surgery [1]. In this second and final part, the authors...

The effect of cocaine or adrenaline dressing during endoscopic sinus surgery

A randomised controlled study of 37 patients took place that underwent endoscopic sinus surgery for chronic rhinosinusitis and received adrenaline or cocaine-soaked patties. The study showed no difference in the mean surgical field scores between adrenaline and cocaine sides. Adequate...

Promising surgical technique for pulsatile tinnitus caused by sigmoid sinus dehiscence?

Pulsatile tinnitus (PT) can be caused by sigmoid sinus dehiscence (SSD). The authors report the results of 17 patients who underwent sandwich surgical technique for sigmoid sinus (SS) wall reconstruction for the treatment of pulsatile tinnitus caused by sigmoid sinus...

Silent sinus syndrome: which approach offers the best outcome?

Silent sinus syndrome (SSS) is a rare condition with patients presenting as spontaneous, painless enophthalmos, hypoglobus, orbital asymmetry, and maxillary sinus collapse on the ipsilateral side. The orbital resorption occurs secondary to negative pressure created in the maxillary sinus by...

Predictors of postoperative improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis

Improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis varies considerably. If elaborate preoperative and intraoperative data could be used to predict the postoperative course, management and length of the follow-up could be adjusted to provide optimal care. Two...

Sinus airflow after FESS using models and fluid dynamics

This is a very interesting study from Australia and New Zealand looking at flow of air into the nose and sinuses after FESS surgery. There is plenty of data regarding computational fluid dynamics for preoperative cases but not much for...

An unrecognised anatomical variant which may help frontal sinus surgery

Anatomic variants in the frontal sinus have significant implications in endoscopic sinus surgery. In this illustrative study, the authors describe a newly-observed anatomical variant – a mucosa lined prism‑shaped space between the most superior part of the nasal septum and...

Microbiome changes after endoscopic sinus surgery: all is not what it seems

As we keep fighting a losing battle with bacteria and antibiotics, it becomes clear that it is not about killing bacteria, not even diminishing the bacterial load, but rather about shifting the different types of bacteria that colonise and live...

Not as rare as we think? Silent sinus syndrome incidence on CT heads

It is relatively uncommon to come across a case of silent sinus syndrome (SSS), but not as rare as the prevalence in the literature might suggest – the authors of this study note that only 100 cases are reported in...

REVISIONS acronym for preoperative imaging review in revision endoscopic sinus surgery

The authors have developed an acronym to aid evaluation of preoperative sinus CT imaging in revision endoscopic sinus surgery (RESS). To determine which pertinent aspects of anatomy to include, a systemic review of studies that investigated anatomic contributions to persistent...

Quo vadis FESS? Future directions in functional endoscopic sinus surgery

Endoscopic sinus surgery is now so ubiquitous that it is hard to imagine a time when it was not part of our clinical practice. Valentin Tomazic takes a look at its early development and looks ahead to endoscopic sinus surgery...

Incidental findings in paranasal sinus Magnetic Resonance Imaging (MRI) studies

Incidental findings in the paranasal sinuses of mucosal thickening and polyps in MRI studies may cause concerns for clinicians and patients. The authors studied MRIs of 982 participants with a mean age of 58.5 years who randomly and independent of...