In the mid-1980s, Kennedy and Stammberger first introduced the concept of endoscopic sinus surgery for benign, inflammatory sinus disease. Since then, functional endoscopic sinus surgery (FESS) has become the standard of care for such disease processes. As expertise, instrumentation and technology have advanced, so too have the applications of FESS. With advent of tools such as powered instrumentation, angled burrs, curettes and image-guided surgery, the endoscopic endonasal approach is now being used routinely.1,2
The nose and paranasal sinuses are lined by pseudostratified ciliated columnar epithelium with goblet cells. Functional cilia and normal production of mucus are necessary to clear the sinuses of inhaled particulate matter and bacteria. Rhinosinusitis is usually preceded by viral upper respiratory tract infection that impedes mucociliary clearance, causing blockage of natural sinus ostia. The primary objective of FESS is to restore paranasal sinus function by re-establishing the physiologic pattern of ventilation and mucociliary clearance. Surgery is always used as an adjunct to medical therapy. The goal is to remove diseased mucosa and bone, preserve normal tissue, and judiciously widen the true natural ostia of sinuses. The osteomeatal complex (OMC) is most often the primary target of endoscopic sinus surgery.3
Key words: Functional endoscopic sinus surgery, nasal polyps, nasal blockage.
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