Sinus surgeons perform functional endoscopic sinus surgery (FESS) in order to open up the sinus passages and relieve any built-up pressure and infection, according to the Mayo Clinic. It is a minimally invasive surgery in which fiber optic telescopes are used for diagnosis and during the procedure, and computed tomography is used to assess the anatomy and identify diseased areas. As sinus surgery has become more advanced, surgeons are able to perform an increasing number of procedures endoscopically without making any incisions.
Opening the Maxillary Sinus
The maxillary sinus is the largest of the sinuses, located just under the cheekbone and there is one on each side. According to the book "Head and Neck Surgery--Otolaryngology" by Byron Bailey, blockage of the maxillary sinus is the most frequent cause of sinus symptoms. Surgeons use functional endoscopic sinus surgery to open up the drainage from the maxillary sinuses by making a small incision in the wall separating the maxillary sinus from the inside of the nose, in a procedure called maxillary antrostomy.
Ethmoid Sinuses
The ethmoid sinuses are multiple small sinus cavities that located on both sides of the face, are deeper than the maxillary sinuses and are between the orbits of the eye and the septum of the nose. The ethmoid sinuses are a frequent source of sinus infections that can spread to the eyes. Sinus surgeons perform FESS to take down the sinus walls and open up the ethmoid sinuses in a procedure called ethmoidectomy. That operation prevents infection from the ethmoid sinuses from invading into the eyes.
Sphenoid Sinuses
The sphenoid sinuses are located deep and near the middle part of the nose, behind the ethmoid sinuses. Several important structures pass right by the sphenoid sinuses, and blockage and infection of the sphenoid sinuses places people at risk for dangerous consequences. According to the book "Surgery" by Josef Fischer, the internal carotid artery, optic nerve, and a structure called the cavernous sinus, which houses large veins and important nerves, are all right next to the sphenoid sinuses. In a procedure called sphenoidotomy, surgeons perform FESS to make a small opening in the front end of the sphenoid sinuses to drain any infectious fluid.
Frontal Sinuses
The frontal sinuses are located on both sides just above the eyes. Infections there frequently cause headaches and can have very serious consequences such as meningitis. The operation to relieve infection from the frontal sinus is called a frontal sinusotomy, and involves endoscopic surgery to open up the floor of the sinus by going through the nose. According to the book "Head and Neck Surgery--Otolaryngology" by Byron Bailey, frontal sinus surgery is the most challenging of the sinus operations.
References
- Mayo Clinic: Endoscopic Sinus Surgery
- "Head and Neck Surgery - Otolaryngology; Byron Bailey; 2006
- "Surgery"; Josef Fischer; 2008
- Sinus Info Center: Endoscopic Sinus Surgery
- American Academy of Family Physicians: Functional Endoscopic Sinus Surgery
