Laryngorhinootologie 2019; 98(06): 429-443
DOI: 10.1055/a-0830-3960
Facharztwissen HNO
© Georg Thieme Verlag KG Stuttgart · New York

Funktionelle endoskopische Nasennebenhöhlenchirurgie (FESS)

Thomas Bitter
,
Orlando Guntinas-Lichius
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Publikationsverlauf

Publikationsdatum:
05. Juni 2019 (online)

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Zusammenfassung

Die funktionelle endoskopische Nasennebenhöhlenchirurgie ist das minimalinvasive chirurgische Standardverfahren zur operativen Behandlung von Patienten mit chronischer Rhinosinusitis. Sie verfolgt das Grundprinzip, die Erkrankung in den NNH zu entfernen und dabei möglichst gesunde Schleimhaut sowie funktionell relevante Strukturen zu schonen. In dieser Übersicht werden Operationsverfahren, Ausstattung, Komplikationen und ihr Management erläutert.

Abstract

Functional endoscopic sinus surgery (FESS) is the minimal-invasive standard procedure for surgical treatment of patients with chronic rhinosinusitis. FESS follows the principle to remove all pathologies within the paranasal sinuses while sparing normal mucosa and all functionally relevant anatomical structures. To understand the functional integrity and the principles of FESS, it is important to have fundamental knowledge of the anatomy of the paranasal sinuses, especially of the orifices to the different sinuses. Normally based on a computed tomography of the paranasal sinuses in two section planes, the FESS surgeon has to reproduce the individual anatomy and to plan the individual extent of the FESS. The severity of the disease and the extent of surgery can be classified. In this review the knowledge to be known by an otorhinolaryngologist is reflected and the main steps of FESS are explained. The equipment will be described. Typical complications of FESS and complication management will be elucidated.