Sinus Surgery

4.10.1 Discuss key landmarks in primary and revision sinus surgery.

Folbe AJ, Casiano RR. Surgical anatomy in revision sinus surgery. In: Kountakis SE, Jacobs JJ, Gosepath J (eds) Revision sinus surgery. Springer, Verlag, Berlin, Heidelberg 2008, pp 53-61.

4.10.2 Review the embryology of the paranasal sinuses.

4.10.3 Review the anatomy and physiology of the osteomeatal complex.

4.10.4 What are haller cells, onodi cells, aggar nasi cells.

4.10.5 List the major and minor complications of FESS.

4.10.6 How do you localize the middle meatus in relation to middle turbinate?

4.10.7 Discuss the surgical management of sphenoid sinus disease.

4.10.8 Discuss the surgical management of frontal sinus disease.

4.10.9 What are nasal antral windows and why have they fallen out of favor?

4.10.10 How would you manage a post-op orbital hematoma?

4.10.11 The middle turbinate: to resect or not to resect?

Havas TE, Lowinger DS. Comparison of functional endonasal sinus surgery with and without partial middle turbinate resection. Ann Otol Rhinol Laryngol. 2000 Jul;109(7):634-40. PMID:10903043 Soler ZM, Hwang PH, Mace J, Smith TL. Outcomes after middle turbinate resection: revisiting a controversial topic. goscope. 2010 Apr;120(4):832-PMID:20232413

4.10.12 While cruising along with a debrider during a FESS case, you suddenly notice clear, pulsatile fluid from the posterior ethmoid cavities. How will you manage this complication? What is the appropriate post –operative management?

4.10.13 Describe the external approaches to the ethmoid sinuses.

4.10.14 List the indications for osteoplastic flap in the management of frontal sinus disease. Describe the procedure.

4.10.15 What is a Draf I, Draf IIA, Draf IIB and Draf III? What is a Lothrop procedure?

4.10.16 Discuss the anatomy and classification of the frontal cells.

Meyer TK, Kocak M, Smith MM, Smith TL. Coronal computed tomography analysis of frontal cells. Am J Rhinol. 2003 May-Jun;17(3):163-8. PMID:12862406

4.10.17 How would you manage a post-op orbital hematoma?

Graham SM, Nerad JA. Orbital complications in endoscopic sinus surgery using powered instrumentation. Laryngoscope. 2003 May;113(5):874-8. PMID:12792325

Sharma S, Wilcsek GA, Francis IC, Lee D, Coroneo MT, Harrison H, Wolf G, Stammberger H. Management of acute surgical orbital haemorrhage: an otorhinolaryngological and ophthalmological perspective. J Laryngol Otol. 2000 Aug;114(8):621-6. PMID:11027054

4.10.18 What is your routine post-operative care after FESS? Will insurance pay for this care?

Thaler ER. Postoperative care after endoscopic sinus surgery. Arch Otolaryngol Head Neck Surg. 2002 Oct;128(10):1204-6. PMID:12365896

4.10.19 Discuss informed consent and sinus surgery.

4.10.20 Educate us on balloon sinuplasty…indications, safety and outcomes.