Functional endoscopic sinus surgery the messerklinger technique pdf

An analysis of functional endoscopic sinus surgery fess for sinonasal disease shahbaz mujtaba ghori, bakht aziz, abid rashid, mansoor basir pal abstract objectives. All aspects of functional endoscopic sinus surgery are covered including an assessment of the technique and a detailed account of both morbid and endos copic anatomy which are important to an. The technique is based on sound wave reflexion analysis in the nasal cavity, and. Anatomy and its variations for endoscopic sinus surgery clinical rhinology. Messerklinger s book endoscopy of the nose, written in the midseventies, explaining the assessment of the physiopathology of sinusitis endoscopic surgery of the nasal sinuses, has remained the standard of care for most inflammatory diseases of the sinuses. Review article functional endoscopic sinus surgery.

Role of functional endoscopic sinus surgery in sinonasal. This functional concept entails reestablishing sinus drainage through its natural ostium and following the natural pathway of mucociliary drainage. Messerklinger s endoscopic techniques and begins working with karl storz, md, to develop a set of instruments for endoscopic sinus surgery. On occasion, functional endoscopic sinus surgery may be required for the drainage of mucocele a blocked sinus that is filled with mucus and slowly expanding. This was soon followed by endoscopic sinus procedures that were, however, still performed according to the principles of radical paranasal sinus surgery of the time. To establish the fess causes fewer complications and significantly improves the symptoms of patients. Mucoceles typically produce no symptoms until they are quite large and compressing the eye or brain. Fess came into existence due to the pioneering work of dr messerklinger and stamburger. The technique of using fiberoptic instrumentation for sinus surgery is becoming more popular. Pdf acoustic rhinometry is an objective method to determine nasal cavity geometry. Previously fess improves voice quality and hyponasality,14.

The technique of using fiberoptic instrumentation for sinus surgery is now becoming more popular. Fess is a minimally invasive, mucosalsparing surgical technique utilized to treat medically refractory crs with or without polyps or recurrent acute rhinosinusitis. Endoscopic sinus surgery has become popular during recent years. Pdf pre and post functional endoscopic sinus surgery nasal cavity. Functional endoscopic sinus surgery 1 functional endoscopic sinus surgery functional endoscopic sinus surgery fess is the mainstay in the surgical treatment of sinusitis and nasal polyps, including bacterial, fungal, recurrent acute, and chronic sinus problems. Written by peterjohn wormald, the richly illustrated text details anatomy and operative treatment of sinonasal conditions such as. By 1972 messerklinger had completed a manuscript for a work on endoscopic diagnosis of the nose, in which the surgical potential of the technique was. Messerklinger advocated functional endoscopic sinus surgery fess aiming at opening the diseased sinus at its natural ostium and possibly widen it to improve sinus drainage and ventilation.

We report the complications of endoscopic sinus surgery in 593 patients in whom 1235 sides were operated on. In one study, over 6 months after sinus surgery, the improvement of voice quality was not stable and reached the preoperative conditions. Functional endoscopic sinus surgery a newer surgical. This is a well written and thoroughly illustrated book which is a must for both e. Anatomy and its variations for endoscopic sinus surgery. Methodologic assessment of studies on endoscopic sinus surgery.

This book literally is a handbook on how to perform functional endoscopic sinus surgery through the nasal cavity. Fess,rhinology, sinus surgery introduction fess functional endoscopic sinus surgery is a relatively recent surgical procedure that uses nasal endoscopes using hopkin rod lens technology through trils to avoid cutting the skin. Evaluation of endoscopic sinus surgery by glasgow benefit. The present chapter illustrates methodology to surgically revise, or complete, functional endoscopic sinus surgery addressing the ethmoid and sphenoid sinuses. Functional endoscopic sinus surgery fess is the primary approach used today for the surgical treatment of chronic sinusitis. Heermann in 1954 began using the surgical microscope for endonasal procedures. The messerklinger technique is a primarily diagnostic endoscopic concept demonstrating that the frontal and the maxillary sinuses are subordinate. Functional endoscopic sinus surgery is a common adjunct to medical therapy in cases of chronic rhinosinusitis and nasal polyposis. History of endoscopic examination of the nasal cavity. Kennedy term these new endoscopically guided diagnostic evaluations and more focused therapeutic.

Indications and complications in the ophthalmic field. Pdf functional endoscopic sinus surgery researchgate. Longterm results of functional endoscopic sinus surgery. Functional endoscopic sinus surgery on a day case out. The use of endoscopes for sinus surgery allowed messerklinger to introduce mucosalsparing techniques that focused on removing key areas of obstruction to allow the restoration of normal mucociliary function. Functional endoscopic sinus surgery is a minimally invasive technique used to restore sinus ventilation and normal function. This dissertation is submitted to the tamil nadu dr. Functional endoscopic sinus surgery fess was developed based on the pathophysiology theory of chronic rhinosinusitis proposed by messerklinger, published in the 50s and 60s. By going through the nose, there are far fewer complications than when traditional open surgical techniques. Role of functional endoscopic sinus surgery in sinonasal diseases. Functional endoscopic sinus surgery the messerklinger.

Ample research supports its record of safety and success. However, the central concepts of functional endoscopic sinus surgery evolved primarily from messerklinger s endoscopic study of mucociliary clearance and endoscopic detailing of. More invasive externalapproach procedures were replaced with functional endoscopic sinus surgery fess, which is now the standard of care for. Pre and post functional endoscopic sinus surgery nasal. The procedure of ress was completed as described in fullhouse fess fhf approach, involving complete removal of all nasal polyps along with a full maxillary antrostomy, total ethmoidectomy, wide. Previous studies also revealed conflicting results regarding the functional endoscopic sinus surgery fess and its effect on the voice. Functional endoscopic sinus surgery comparison in a tertiary care hospital. Simion zinreich, md, a radiologist, develops ct parameters for sinus imaging. Pre and post functional endoscopic sinus surgery nasal cavity. The most suitable candidates for this procedure have recurrent acute or. The fully updated comprehensive anatomical guide on surgery of the paranasal sinuses and skull base. Messerklinger was not the first to use endoscopes in the nose or the sinuses. Rars has been defined as four episodes per year of acute.

It was walter messerklinger from the styria city of graz in austria who performed much of the basic research that underpinned this surgery and his department associate. Functional endoscopic sinus surgery fess was developed based on the. The purpose of functional endoscopic sinus surgery is to reestablish ventilation and mucociliary clearance of the sinuses. Endoscopic diagnosis and surgery of the paranasal sinuses and anterior skull base. The authors are respected in the field of otolaryngology and this reference manual should be useful to both trainees and practitioners. Prior to the introduction of functional endoscopic sinus surgery, several surgeons had begun to use telescopes to perform surgical procedures in the nose and sinuses.

Functional endoscopic sinus surgery the messerklinger technique oliver kaiser. The early history and development of endoscopic sinonasal. The evolution of functional endoscopic sinus surgery. Functional endoscopic sinus surgery fess is often a noninvasive medical procedure that discloses sinus air cells and sinus ostia openings by having an endoscope. This goal is achieved primarily by the endoscopic removal of disease from key areas of the anterior ethmoid and middle meatus. Functional endoscopic sinus surgery is generally reserved for those patients with chronic rhinosinusitis inflammation of the mucosal tissues of the nose and sinuses that persists despite aggressive medical treatment typically antibiotics, oral steroids, topical nasal sprays, mucusthinning drugs, andor antiallergy treatments. The messerklinger technique is a primarily diagnostic endoscopic concept demonstrating that the frontal and the maxillary sinuses are subordinate cavities.

Pdf selecting the best approach to the frontal sinus. Functional endoscopic sinus surgery patient information. Effect of functional endoscopic sinus surgery on the voice. Functional endoscopic sinus surgery mcgovern medical school. Since then, many studies have been published reporting the. The introduction of functional endoscopic sinus surgery fess into the englishspeaking world in 198586 revolutionized the surgical management and treatment of chronic inflammatory conditions of the nose and sinuses.

Disease usually starts in the nose and spreads through the ethmoidal prechambers to the frontal and maxillary sinuses, with infections of these latter sinuses thus usually being of secondary nature. Fess is recommended in patients who have failed medical therapy for their chronic sinus conditions. As in the acclaimed prior editions, endoscopic sinus surgery, fourth edition focuses strictly on anatomy, 3d reconstruction, and stepbystep surgical techniques. The objective of this study was to assess patients quality of life up to two years after endoscopic sinus surgery. Functional endoscopic sinus surgery the introduction of endoscopic surgical techniques during the 1980s drastically changed the treatment for patients with recurrent or refractory rhinosinusitis. In his original studies, this author used cadaver heads, impregnating the paranasal sinus mucus with a variety of substances. The messerklinger technique is an endoscopic approach to sinus surgery designed to be minimally invasive and preserve mucosa and hence physiological function. Symptoms after functional endoscopic sinus surgery is a bonafide work done by me at government kilpauk medical college under the guidance and supervision of prof. Functional endoscopic sinus surgery fess has revolutionized surgical care, opening new horizons in the management of chronic rhinosinusitis and other paranasal sinus disorders messerklinger established and reinterated the importance of the sinus ventilation and pattern of mucociliary clearance. Fortyfive patients had complications, in three of whom they were systemic. Reported results of these techniques have been very good.

Two hundred and ten patients suffering from chronic hyperplastic rhinosinusitis refractory to medical treatment were subjected to functional endoscopic sinus surgery using the classical messerklinger technique mt fess. Anatomy, threedimensional reconstruction, and surgical technique. Chronic rhinosinusitis crs is an inflammatory condition in which the nose and at least one sinus become swollen and interfere with mucus drainage. In 1978, messerklinger documented the first systematic and detailed description of endoscopic findings of the sinonasal cavity. Functional endoscopic sinus surgery american family. Messerklinger was able to establish that the maxillary and frontal sinuses. Using fess just like a sinus surgical method is becoming broadly accepted.

The extent of surgery for inflammatory disease has been a matter of controversy. Endoscopic sinus surgery techniques a laboratory dissection manual, endopress, tuttlingen, 2012 stammberger h. Anaesthetic concerns for functional endoscopic sinus surgery. Fess technique was not brought into common use until the work of messerklinger in 1978. This will be discussed in the context of preoperative planning, necessary instrumentation, specific. In the latter group, infundibulotomy was done from behind by removal of the bulla ethmoidalis aided by 70 and 90. A study of different endoscopic surgery procedures in. Functional endoscopic sinus surgery is most commonly used to treat chronic rhinosinusitis, only after all nonsurgical treatment options such as antibiotics, topical nasal corticosteroids, and nasal lavage with saline solutions have been exhausted. The messerklinger technique has proved to be suitable for smaller ent. By going through the nose, there are far fewer complications than when traditional open surgical techniques were used. Functional endoscopic sinus surgery fess is a technique described by dr. Outcomes for revision endoscopic sinus surgery ress are rarely reported in relation to technique.