Assessment of Powered Instrumentation with Functional Endoscopic Sinus Surgery in the Management of Chronic Sinusitis

Abstract

Sinus surgery, in part, because of the critical anatomic relationships and surgical dangers and in part, because of a lack of knowledge of patho-physiology has always been controversial. The choice of an operative approach, either external or intranasal, has been one source of •controversy. The extent of surgery has been another source of controversy.

Use of rigid intranasal endoscope, while providing answers for many controversial questions, has raised many new areas of discussion. The initial instrumentation available for endoscopic sinus surgery consisted primarily of instruments without suction which tend to strip mucosa from the underlying bone (Blakesley's forceps and cupped forceps). (Grab and tear) instrument.

The introduction of suction forceps was an advance in this regard but not completes solution. Suction was not available for all instruments.

The most significant development in addition to the suction forceps is the availability of thru-cutting instrumentation. Low profile heads and ergonomic designs in addition to convenient shapes which permit the goal of FESS. Fess goal should be to open the diseased sinus at the natural ostium and, whenever