الفهرس 
Surgical anatomy of the paranasal sinuses
Sphenoid functional unitOnly 14 pages are availabe for public view
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Abstract
Functional endoscopic sinus surgery (FESS) is an important adjunct used in the treatment of chronic rhinosinusitis. It has largely replaced the external approaches for treating chronic rhinosinusitis refractory to medical management.Various instruments were developed over the years that are used to remove anatomic obstruction and to restore function within the drainage pathways of the sinuses.(1-3) Functional ESS (FESS) was pioneered in the 1970s by Messerklinger, with the aid of the Hopkins rod tele-scope, the aim being to preserve nasal mucosa.(4,5) Long-term success rates of FESS is very high, with over 90% symptomatic improvement. Failure does occur, however, with reported rates between 2 and 24% after primary surgery. Reasons for failure may be due to several factors including an incorrect diagnosis, a poor surgical technique, an inadequate surgery, postoperative scarring, inadequate postoperative medical therapy, or recurrent disease. (6-9) Once it has been determined that the patient is a suitable candidate for revision surgery, the next challenge is to provide safe and complete surgery in a situation where anatomic alterations from previous surgery increase the degree of difficulty and risk of complications.