Revision Sinus Surgery (eBook)

Dedication 5
Preface 7
Contents 9
Contributors 13
Imaging Anatomy in Revision Sinus Surgery 19
Introduction 19
Caldwell- Luc and Nasoantral Windows 20
Imaging Anatomy in Post- FESS Ostiomeatal Complex 20
Frontal Sinus Drainage Surgery 24
Endoscopic Sphenoidotomy 27
Negative Prognostic Findings Post- FESS Conclusion 28
References 28
Indications for Revision Endoscopic Sinus Surgery 31
Introduction 31
Indications for Surgery 32
Preoperative Workup 34
References 36
Predictors of Failure of Primary Surgery 37
Introduction 37
Patient Selection Factors 38
Comorbidities 38
Disease Factors 39
Conclusion 40
References 40
Pathophysiology of Inflammation in the Surgically Failed Sinus Cavity 43
Introduction 43
Intrinsic factors 44
External Factors 48
Environmental Factors 49
Acquired Immunodeficiency Disorders 49
Immunopathophysiology 50
Conclusion 50
References 50
Medical Management after Primary Surgery Failure and Preoperative Medical Management 55
Introduction 55
Etiological Evaluation and Preoperative Medical Treatment 56
Postoperative Care and Long-Term Medical Management to Prevent Recurrence 58
Future Directions 60
References 60
New Technologies for Revision Sinus Surgery 63
Introduction 63
Intraoperative Imaging 64
Endoscopic Sinus Surgery Simulator 65
Balloon Sinus Ostial Dilatation 67
References 68
Surgical Anatomy in Revision Sinus Surgery 71
Introduction 71
Nasal Cavity 72
Maxillary Sinus 72
Ethmoid Labyrinth 75
Sphenoid Sinus 76
Frontal Sinus 76
Conclusion 79
References 79
Surgical Instruments in Revision Endoscopic Sinus Surgery 81
Introduction and Background 81
Videoscopy and Visualization 82
Mucosal- Sparing Instrumentation 82
Powered Instrumentation 84
Modifications of Traditional Instruments 85
Image- Guided Instrumentation 86
Summary 86
References 87
Anesthetic Choices, Techniques, and Injections 89
Introduction 89
Anesthetic Choices 89
Pharmacology of General Anesthesia 90
Balanced Anesthesia Versus TIVA 91
Pharmacology of Local Anesthetics 91
Injections 92
Techniques 93
Conclusions 94
References 94
Tips and Pearls in Revision Sinus Surgery 97
Introduction 97
Patient Selection 98
Nasal Endoscopy 98
CT Scan Review 100
Preoperative Workup 101
Surgical Equipment 101
Surgical Technique 103
Postoperative Care 106
Conclusion 107
References 107
Septal and Turbinate Surgery in Revision Sinus Surgery 109
Introduction 109
Anatomy 109
Association with Rhinosinusitis 111
Preoperative Workup 111
Surgical Technique 111
References 117
Revision Endoscopic Surgery of the Ethmoid and Maxillary Sinus 119
Introduction 119
Causes for Surgical Failures 119
Preoperative Workup and Indications 122
Technique 123
Complications 124
Postoperative Care 124
Outcomes 125
References 125
Revision Endoscopic Surgery of the Sphenoid Sinus 127
Introduction 127
Evaluation 127
Surgery 130
Postoperative Care and Outcomes 131
Conclusion 132
References 132
Endoscopic and Microscopic Revision Frontal Sinus Surgery 135
Introduction 135
Preoperative Workup 136
Surgical Technique 138
Postoperative Care 141
Outcomes and Complications 142
References 143
Revision Endoscopic Frontal Sinus Surgery 145
Introduction 145
Patient Selection/ Preoperative Evaluation 145
Preoperative Assessment/ Planning 146
Relevant Anatomy 147
Operative Techniques 148
Conclusions 152
References 152
Postoperative Medical Management 153
Introduction 153
Postoperative Debridement 154
Nasal Saline Irrigation and Lavage 155
Corticosteroids 155
Antibiotic Therapy 156
Allergic Fungal Sinusitis 158
Conclusion 158
References 158
Evaluation and Treatment of Recurrent Nasal Polyposis 161
Introduction 161
Evaluation 162
Medical Treatment 165
Patient Selection for Surgical Treatment 166
Perioperative Medical Care 166
Surgical Technique 166
Surgical Outcomes 167
Future Directions 167
References 167
Revision Surgery for Allergic Fungal Rhinosinusitis 171
Introduction 171
Clinical Presentation 171
Imaging 172
Medical Treatment 172
Revision Surgery 173
Complications 174
Open Approaches 174
Conclusions 175
References 175
Revision Endoscopic Surgery for Benign Sinonasal Tumors 177
Introduction 177
Inverted Papilloma 178
Other Benign Neoplasms 182
Conclusion 183
References 183
Recurrent Cerebrospinal Fluid Leaks and Meningoencephaloceles 185
Introduction 185
Indications for Transnasal Endoscopic Repair of CSF Leaks and Meningoencephaloceles 186
Preoperative Workup 186
Perioperative Adjuncts 188
Surgical Techniques 189
Potential Complications 192
Factors Contributing to Failure in Skull- Base Repair 193
Postoperative Care 193
Outcomes 194
References 194
Delayed Complications Following Sinus Trauma 197
Introduction 197
Rhinosinusitis 197
Mucoceles 198
Foreign Bodies 199
Silent Sinus Syndrome 199
Paranasal Sinus Epidermoids 200
Traumatic Aneurysms 200
Cerebrospinal Fluid Leak 201
Conclusion 201
References 201
Recurrent Mucoceles 203
Introduction 203
Epidemiology 203
Pathophysiology 204
Presentation 204
Preoperative Workup 204
Surgical Technique 205
Postoperative Care 209
Outcomes 210
Conclusion 210
References 210
Allergy and the Patient Requiring Revision Sinus Surgery 211
Introduction 211
Allergy and the Pathogenesis of Chronic Rhinosinusitis 211
Allergic Rhinitis 212
Conclusion 215
References 215
Staging of Disease after Sinus Surgery Failure 217
Introduction 217
CRS and NP 217
Endoscopy 221
Imaging 221
Other Methods of Assessment 229
Use of Staging in Outcome Research 230
Staging for Neoplasia 231
Conclusion 231
References 231
Headache and the Patient who Failed Primary SinusSurgery 235
Introduction 235
Differential Diagnosis 236
Revision Endoscopic Sinus Surgery 238
Summary 239
References 239
Complications in Revision Sinus Surgery: Presentation and Management 241
Introduction 241
Orbital Musculature Injury 243
Orbital Hematoma 244
Optic Nerve Injury 246
Carotid Injury 247
CSF Leak/ Skull- Base Penetration 248
Conclusion 250
References 251
Revision Dacryocystorhinostomy 253
Introduction 253
Preoperative Evaluation 254
Revision Dacryocystorhinostomy 256
Complications 260
Conclusion 261
References 261
Revision Endoscopic Transsphenoidal Hypophysectomy 263
Introduction 263
Indications for Surgery 263
Contraindications for Revision Endoscopic Pituitary Surgery 264
Preoperative Evaluation 264
Surgical Technique 265
Tips to Avoid Complications 266
Complications 267
Conclusion 267
References 267
Revision Image- Guided Functional Endoscopic Sinus Surgery 269
Introduction 269
System Components 270
Registration 271
Assessment of Surgical Navigation Accuracy 272
Preoperative Considerations and Surgical Indications 273
Specific Applications 273
Limitations of Revision IG- FESS 282
Special IGS Techniques 282
Outcomes 283
Conclusion 284
References 284
Revision Endoscopic Sinus Surgery in Children 287
Introduction 287
Failure of ESS 288
Indications 290
Contraindications 290
Preoperative Workup 290
Surgical Technique 290
Complications 291
Postoperative Care 291
Outcomes 291
References 291
Open Approaches after Failure of Primary Sinus Surgery 293
Introduction 293
Indications 294
Procedures 294
References 297
“ Above and Below” Techniques in Revision Sinus Surgery 299
Background 299
Preoperative Workup 300
Indications/ Contraindications 300
Surgical Technique 301
Postoperative Care 303
Complications 304
Outcomes 304
Conclusion 304
References 305
Revision Endoscopic Skull- Base Surgery 307
Introduction 307
Preoperative Workup 309
Surgical Techniques 311
Postoperative Care 315
Complications and Outcomes 316
Conclusion 316
References 316
Stenting in Revision Sinus Surgery 319
Introduction 319
Stenting Materials and Design 319
Preoperative Assessment 321
Indications for Stenting 321
Duration of Stenting 322
Surgical Technique 323
Postoperative Stent Management 324
Conclusion 325
References 325
Use of Intravenous Antibiotics in Sinus Surgery Failures 327
Introduction 327
Indications for Intravenous Antibiotics 327
Effectiveness of Intravenous Antibiotics 328
Pediatric Intravenous Antibiotic Treatment 330
Method of Delivery of Home- Infused Intravenous Antibiotics 331
Complications of Intravenous Antibiotics 331
Benefits of Intravenous Antibiotics 332
Conclusion 332
References 333
Objective and Subjective Outcomes after Revision Sinus Surgery 335
Introduction 335
Outcomes Assessment in Rhinosinusitis 335
Available Validated Health Status Instruments for Use in Rhinosinusitis 339
Results after Revision Endoscopic Sinus Surgery 339
Conclusions 345
References 345
Bioabsorbable Materials in Revision Sinus Surgery 347
Introduction 347
Classification of Absorbable Biomaterials 348
Selection of Material 348
Additional Considerations and Future Directions 352
References 352
Endoscopic Approach after Failure of Open Sinus Procedures 355
Introduction 355
Indications 356
Contraindications 356
Preoperative Workup 356
Surgical Techniques 358
Postoperative Care 362
Complications and Outcomes 362
References 363
Subject Index 365