Endoscopic Sinus Surgery. Section 6 ( قسمت ششم فایل ). Bakhshaee M, MD Rhinologist, Assistant Prof. MUMS. Frontosphenoethmoidectomy. Frontosphenoethmoidectomy. This includes an anterior ethmoidectomy, posterior ethmoidectomy, sphenoid sinusotomy along with opening the frontal recess.
Section 6 (قسمت ششم فایل)
Bakhshaee M, MD
Rhinologist, Assistant Prof. MUMS
This is mainly reserved for those with persistent symptoms after anterior ethmoid surgery.
If visibility is poor because of polyps or bleeding, the sphenoid sinus can safely be approached by staying close to the septum in the midline and palpating with the straight sucker up the posterior wall of the sphenoid
It is advisable not to open the sphenoid ostium downward to a level lower than half the total height of the sinus, as a branch of the sphenopalatine artery runs along its anterior wall and if cut this can bleed briskly.
By preserving “all” the mucosa in the olfactory area on the septum and the turbinates, as well as opening the olfactory cleft.
If there is a concha bullosa, the lateral half of the turbinate can be resected.
Hypertrophied inferior turbinate
Edematous middle turbinate
Important not to request a CT scan in the initial management if patients unless there are specific reasons to do so.
A comparison between a T2-weighted image (fluid bright), a T1-weighted image (fluid dark), and a T1-weighted image with nonionic contrast provides useful information about soft-tissue lesions
If there is intracranial or intraorbital involvement from an atypical infection or inflammatory process