• Home
  • Practice Focus
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
    • How I Do It
    • TRIO Best Practices
  • Business of Medicine
    • Health Policy
    • Legal Matters
    • Practice Management
    • Tech Talk
    • AI
  • Literature Reviews
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Career
    • Medical Education
    • Professional Development
    • Resident Focus
  • ENT Perspectives
    • ENT Expressions
    • Everyday Ethics
    • From TRIO
    • The Great Debate
    • Letter From the Editor
    • Rx: Wellness
    • The Voice
    • Viewpoint
  • TRIO Resources
    • Triological Society
    • The Laryngoscope
    • Laryngoscope Investigative Otolaryngology
    • TRIO Combined Sections Meetings
    • COSM
    • Related Otolaryngology Events
  • Search

Strategies for Improving FESS Outcomes

by Pippa Wysong • January 1, 2007

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version

In general, with the maxillary sinus, the natural ostium must be included in the antrostomy to prevent recirculation, Dr. Palmer said. Consider a ‘mega-ostium’ or endoscopic medial maxillectomy in cases of recurrent maxillary sinusitis, he said.

You Might Also Like

  • Maximizing Results and Minimizing Complications during FESS
  • Case Studies in Endoscopic Sinus Surgery
  • How to: Improving the Outcomes of Anterior Septal Perforations Repair with Combined Flaps
  • Does Balloon Catheter Sinuplasty Have a Role in the Surgical Management of Pediatric Sinus Disease?
Explore This Issue
January 2007

Ethmoid Issues

Finally, panelists discussed issues related to the ethmoid sinus.

Dr. Palmer pointed out that with posterior ethmoid entry, watch where the perforation is done and avoid CSF leaks. Enter the basal lamina inferiorally and medially-the site acts as a fulcrum to direct the angle of the endoscope, he said.

CSF leaks can occur via surgical trauma in the posterior ethmoid roof or the lateral lamella of the cribriform plate. Leaks can be dramatic if caused by the powered instruments that are used to ‘skeletonize’ the skull base.

The key to safe surgery in the posterior ethmoid and sphenoid is to always know where the superior turbinate is-as there are not many landmarks in this region for endoscopic navigation. Also, be careful when entering the sphenoid.

You need to identify the variations on the preoperative CT, he said. At the same time, Dr. Palmer cautioned doctors to not blindly trust image-guided devices.

A key tip when it comes to the ethmoid sinus is to do complete removal of the bony septa in the ethmoid cavity, since this will help prevent recurrence in a complete ethmoidectomy, said Dr. Palmer. Paying special attention to the anatomy of the ethmoid roof and the lamina papyracea will help prevent complications.

©2007 The Triological Society

Pages: 1 2 3 | Single Page

Filed Under: Articles, Clinical, Features Issue: January 2007

You Might Also Like:

  • Maximizing Results and Minimizing Complications during FESS
  • Case Studies in Endoscopic Sinus Surgery
  • How to: Improving the Outcomes of Anterior Septal Perforations Repair with Combined Flaps
  • Does Balloon Catheter Sinuplasty Have a Role in the Surgical Management of Pediatric Sinus Disease?

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

The Triological SocietyENTtoday is a publication of The Triological Society.

Polls

Do you use AI-powered scribes for documentation?

View Results

Loading ... Loading ...
  • Polls Archive

Top Articles for Residents

  • Applications Open for Resident Members of ENTtoday Edit Board
  • How To Provide Helpful Feedback To Residents
  • Call for Resident Bowl Questions
  • New Standardized Otolaryngology Curriculum Launching July 1 Should Be Valuable Resource For Physicians Around The World
  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Popular this Week
  • Most Popular
  • Most Recent
    • How to: Positioning for Middle Cranial Fossa Repair of Superior Semicircular Canal Dehiscence

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • Endoscopic Ear Surgery: Advancements and Adoption Challenges 

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • Complications for When Physicians Change a Maiden Name

    • The Importance of Time Away
    • Endoscopic Ear Surgery: Advancements and Adoption Challenges 
    • Reflections from a Past President of the Triological Society
    • ENT Surgeons Explore the Benefits and Challenges of AI-Powered Scribes: Revolutionizing Documentation in Healthcare
    • How To: Open Expansion Laryngoplasty for Combined Glottic and Subglottic Stenosis

Follow Us

  • Contact Us
  • About Us
  • Advertise
  • The Triological Society
  • The Laryngoscope
  • Laryngoscope Investigative Otolaryngology
  • Privacy Policy
  • Terms of Use
  • Cookies

Wiley

Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1559-4939