Summary
Our endoscopic concept of the diagnosis and surgical treatment of recurrent sinusitis
is based on Messerklinger's finding that almost all infections of the frontal and
maxillary sinuses are rhinogenic. They are secondary to infection foci in their prechambers
in the anterior ethmoid, especially in the ethmoidal infundibulum and the frontal
recess, spreading from there to the dependent larger sinuses.
Consequently, our functional endoscopic sinus surgery is aimed at these infection
foci in the ethmoid, clearing mucosal contact areas, stenotic clefts and diseased
cells. Ventilation and drainage of frontal and maxillary sinuses are re-established
via their natural routes. There is no need for fenestration via the inferior meatus.
Disease in the larger sinuses then usually heals without the mucosa having actually
been touched. In our experience, this leaves hardly any indication for external or
more radical procedures.
The technique of endoscopic diagnosis and surgery are described in detail.
Key words:
Functional endoscopic sinus surgery - Messerklinger technique - Ethmoid disease -
Rigid endoscopes
