Download Endoscopic Sinus Surgery Dissection Manual: A Stepwise: by Roy Casiano PDF

By Roy Casiano

Univ. of Miami, FL. Manual/atlas illustrates an anatomically established, stepwise procedure for studying to accomplish endoscopic sinus surgical procedure. this method is used on the college of Miami, Florida and combines all of the top attributes of earlier methodologies. considerable half-tone illustrations are integrated. CD-ROM includes textual content and illustrations.

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Extra info for Endoscopic Sinus Surgery Dissection Manual: A Stepwise: Anatomically Based Approach to Endoscopic Sinus Surgery

Example text

SP = supreme turbinate. IM = inferior meatus. MM = middle meatus. Asterisks = sphenoethmoidal recess. LS = lacrimal sac. D = lacrimal duct. PF = posterior fontanelle. NS = nasal septum. ET = eustachian tube orifice. Small arrows in the endoscopic view denote the posterior choanal arch. 22 B. Chapter 3 Inferior Turbinoplasty (Figure 12) An endoscopic inferior turbinoplasty may be indicated when there is poor endoscopic visualization of the nasal and posterior choanal structures or nasal obstruction due to turbinate hypertrophy (38,39).

The solid black line points superiorly. The unsuspecting surgeon may inadvertently penetrate the orbital wall thinking he or she is dissecting “superiorly” into the ethmoid cavity on the monitor. Conversely, the roof of the ethmoid may be penetrated if one incorrectly judges the direction of dissection “medially” on the monitor. Basic Dissection 39 G. Anterior Ethmoid Air Cells (Figures 24 and 25) The anterior ethmoid air cells run medial to the horizontal antrostomy ridge. In advanced disease or distorted cavities, the surgeon first performs an inferior ethmoidectomy (anterior and/or posterior, depending on the extent of disease) to identify the medial orbital wall inferiorly (26,37).

IT = inferior turbinate. Basic Dissection 45 the ethmoid is identified laterally. The surgeon should observe that the roof of the anterior ethmoid roof slopes medially by as much as 45 degrees. The mucosa along the orbital wall and ethmoid roof is left undisturbed, whenever possible, to avoid granulations, osteitis, prolonged healing, osteoneogenesis, and fibrosis. Only the mucosa overlying the septations is removed. This can be facilitated by the use of cutting forceps or powered instrumentation.

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