ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Case Studies in Endoscopic Sinus Surgery

by Pippa Wysong • February 1, 2007

  • Tweet
  • Email
Print-Friendly Version

Even in patients with relatively common sinus disease, decision making about endoscopic sinus surgery (ESS) can be difficult, and not all cases are the same. This was one of the points brought out in discussion of a series of cases at the Ask the Experts Panel: An Endoscopic Sinus Surgery Potpourri at the annual AAO-HNS conference in Toronto in September. During the panel, five leading sinus surgeons discussed several challenging cases.

You Might Also Like

  • Endoscopic Sinus Surgery Rates Increase Since 2000
  • Dramatic Increase in Endoscopic Sinus Surgery Since 2000
  • Dramatic Increase in Endoscopic Sinus Surgery Since 2000
  • Drugs, Surgery, Endoscopic Sinus Surgery As Remedies for Chronic Rhinosinusitis
Explore This Issue
February 2007

Two Teen Cases

The first two cases presented were of teen patients, the first being presented by David Kennedy, MD, Vice Dean for Professional Services at University of Pennsylvania School of Medicine, who also moderated the session.

James N. Palmer, MD

James N. Palmer, MD

A 15-year-old male who had failed endoscopic frontal sinusotomy three months previously came to Dr. Kennedy’s clinic. The teen complained of severe frontal headaches, had no major nasal symptoms, but had missed numerous days of school because of the headaches.

The headaches were severe and debilitating, Dr. Kennedy said. But there were no migraine prodromes, and a neurologist couldn’t help. A referring physician believed the headaches were from frontal sinus disease, but a surgeon had been unable to open the frontal sinus.

Based on this amount of information, panelists discussed whether to pursue further endoscopic treatments or opt for more aggressive treatment. Possibilities to consider for disease included migraine, chronic frontal sinusitis, mucocele, meningocele, or tumor, Dr. Kennedy said.

Panelists agreed that further imaging was needed. Dr. Kennedy reported that based on MRI studies an endoscopic treatment was done, after discussion with the patient and his mother about other potential causes of the headache. Surgical findings revealed scarring and mucosal disease in the left anterior ethmoid, with pus in a closed-off area of the frontal sinus.

The anteriorly placed frontal sinus was entered endoscopically with minimal trauma and without the necessity for a drill, and the area stayed open postoperatively, Dr. Kennedy said. The most important aspect of postoperative care in this case was endoscopic debridement and endoscopic follow-up.

However, despite the now patent frontal sinus, and the presence of pus at the time of surgery, the patient’s headaches did not resolve. In this case, it was shown that the cause of the headaches was not sinusitis, as previously believed. Furthermore, a minimally invasive procedure proved to be the best approach.

We avoided doing any harm with a minimally invasive endoscopic approach. If this patient had been approached with an open approach, the subsequent CT changes would have made it impossible to ever know if this had really been the cause of the patient’s headaches, Dr. Kennedy said.

Pages: 1 2 3 4 | Single Page

Filed Under: Articles, Clinical, News Issue: February 2007

You Might Also Like:

  • Endoscopic Sinus Surgery Rates Increase Since 2000
  • Dramatic Increase in Endoscopic Sinus Surgery Since 2000
  • Dramatic Increase in Endoscopic Sinus Surgery Since 2000
  • Drugs, Surgery, Endoscopic Sinus Surgery As Remedies for Chronic Rhinosinusitis

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Weaning Patients Off of PPIs
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Podcasts Becoming More Popular Method of Education for Otolaryngologists
    • How to Embrace Optimism in the Midst of the COVID-19 Pandemic
    • Tips on How to Approach Conversations with Patients about the COVID-19 Vaccine
    • Steps You Should Take to Protect Your Voice and Hearing During Telemedicine Sessions
    • Routine Postoperative Adjunct Treatments Unnecessary for Idiopathic Cerebrospinal Fluid Leaks

Polls

Have you spoken with your patients about receiving the COVID-19 vaccine?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.