Endoscopic Sinus Surgery- Surgical Steps with Implications in Intraoperative Complications

Abstract

Objective: Endoscopic sinus surgery is a worldwide performed operation which has gained acceptance as the primary treatment modality in paranasal sinus diseases. Any surgeon performing this surgery needs a valid treatment algorithm. Inappropriate surgical techniques may lead to failure and complications. Proximity of the surgical field to the critical structures poses difficulties to the surgeon. Too much removal of the normal structures and too little removal of the diseased tissues can have undesirable consequences. Although several techniques have been defined for each step, highlight ing critical points in a concise manner will be beneficial.Methods: This review article aimed to enlight the complex paranasal sinus and relevant anatomy, define the intraoperative maneuvers to achieve a successful sinus surgery while avoiding surgeon-related complications. Books and journals were reviewed comprehensively. Classic techniques and contemporary aspects of the endoscopic sinus surgery were assembled.Results: Paranasal sinus surgical anatomy and diseases show great variations. Endoscopic sinus surgery is performed in ameliorating paranasal sinus diseases. Improving the efficiency and safety of this surgery remains an important matter. There is a narrow border between suggested surgical steps and perilous complications. A thorough surgical anatomy knowledge and meticulous surgical methods needs to be defined.Conclusion: Sinus surgeon must carefully evaluate the underlying disease process, apply a precise surgical method, avoid possible complications, and should take necessary measures in case of a complication. A systematic surgical technique is mandatory for success.