Download A Dissection Course On Endoscopic Endonasal Sinus Surgery by Werner Hosemann, J Fanghänel PDF

By Werner Hosemann, J Fanghänel

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A Dissection Course On Endoscopic Endonasal Sinus Surgery • Up to this point, removal of the anterior ethmoidi has exposed the frontal sinus ostium (Draf type I drainage). The ostium can be enlarged by means off the type II a and b and type III drainage procedures (Figs. 30 and 31). • The curved curette is used to enter tissue spaces3 and for probing (without perforating bony lamellae).. • In most cases a "recess" located just lateral to the vertical lamella of the middle turbinate will lead". toward the frontal sinus.

In two-thirds of cases the carotid artery forms a prominence in the lateral sinus wall (Figs. 43 and 44). The optic nerve forms a significant prominence in the anterosuperior lateral wall in approximately 20% of cases. In one-third of these cases the optic canal passes more or less freely through a broad sphenoid sinus. The free course of the nerve through the sphenoid sinus is the result of a heavily pneumatized anterior process of the clinoid. In rare cases (3%) the entire canal lies in the lateral wall of a posterior ethmoid cell {DeLano and Zinreich 1996).

17 Endonasal Extension of the Maxillary Sinus Approach, Analogous to the Denker Operation The opening between the nasal cavity and maxillary sinus after the medial maxillectomy (see above) can be enlarged further. This is done by starting at the piriform aperture and progressively removing the "medial pillar" of the midface (portions of the medial maxilla and medial anterior wall of the maxillary sinus). First strip the periosteum over the maxilla, starting from the nasal vestibule, and then remove the bone in small pieces.

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