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Advances in Surgery: Extended Procedures for Sinonasal Polyp Disease. Adv Otorhinolaryngol 2016;79:148-57

Date

07/29/2016

Pubmed ID

27466857

DOI

10.1159/000445153

Scopus ID

2-s2.0-84992092205   7 Citations

Abstract

In the standard functional endoscopic sinus surgery (FESS) procedure, the amount of dissection is often determined by the extent of disease with the goal to preserve as much normal mucosa as possible while restoring ventilation and reestablishing mucociliary clearance. A subset of patients with chronic rhinosinusitis with nasal polyposis (CRSwNP), however, may continue to have persistent mucosal inflammatory and aggressive polyp regrowth despite standard FESS and maximal pharmacology therapy, leading to recurrent and recalcitrant disease. Advanced endoscopic surgery techniques such as the modified endoscopic medial maxillectomy, endoscopic modified Lothrop procedure, otherwise known as a Draf 3 frontal sinusotomy, and nasalisation or radical ethmoidectomy are extensive surgical procedures to maximize disease clearance while providing sizeable drainage pathways for effective postoperative surveillance and topical delivery of medications. Studies have shown a decreased risk of revision surgery as well as a longer time interval for revision surgery in patients with refractory CRSwNP who have undergone extensive sinus surgery for polyps.

Author List

Southwood JE, Loehrl TA, Poetker DM

Authors

David M. Poetker MD Chief, Professor in the Otolaryngology department at Medical College of Wisconsin
Jessica E. Southwood MD Assistant Professor in the Otolaryngology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Chronic Disease
Drainage
Endoscopy
Humans
Nasal Polyps
Otorhinolaryngologic Surgical Procedures
Rhinitis
Sinusitis