Cables 152, 153 Camera systems , video stack/cameras , 153 Cantholysis, inferior

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1 296 A Abscess periorbital 45 goal of surgery 44 subperiosteal 18, 20 Accessory ostium , anterior to uncinate process 114, 115 in posterior fontanelle 116 Adenoameloblastoma 43 Adenocarcinoma 17, 42, surgical management 274, , 278 Adenoid hypertrophy 17 18, 19 Adenoma, pleomorphic 268 Adhesions 146, 184, 290 Adie s pupil 134 Agger nasi cells 66, 73, 75, 85, 111 preoperative CT review 136, 137, 138 AIDS 32 Allergen avoidance 32, 287 Allergic rhinitis see Rhinitis Allergy 116, 280, diagnosis 286 intermittent 286 patient information persistent 286 tests 31, 132 treatment allergen avoidance 32, 287 see also Rhinitis Amitriptyline 23, 24 Amoxicillin Amphotericin 35 Anatomical variations agger nasi cells 111 concha bullosa 112 middle turbinate uncinate process Ancillary staff 154 Anesthesia general goals 169 local 148 Angiofibroma 24, 118, 119, 235 as indication for MRI 125 juvenile 125, 127 management 146, Anosmia 102 postoperative Anterior ethmoid artery , 140, 173, 181 dehiscence 181 management indications 207 surgical technique useful instruments 209 perioperative bleeding surgical anatomy Antibiotic treatment non-response 130, 131 postoperative 191 rhinosinusitis Antihistamines 32, 287 Antrochoanal polyp 15 16, 43, 118, 124 surgical treatment 15, 51 goal of 42 Aspergillosis 12 15, 35, 116, 117 cavernous sinus 271 frontal sinus 70 invasive 126 management 35 postoperative care 191 sphenoid sinus 101, 167 Asthma 29 30, 31, , 132, 280 Asymmetrical skull base 135 Atopy markers 282 B Back-biters 158 Ball probes 63, 64, 156 Barotrauma, goal of surgery 44 Basal lamella 66 Belluci scissors 159, 160 Benign tumors see Tumors Biopsy 272 Bipolar suction diathermy 162, 172 Black halo 179, 180 Blakesley forceps 157 Bleeding 28, 45 perioperative anterior ethmoid artery sphenopalatine artery 171 postoperative , 192, 289 Bronchiectasis Bulla ethmoidalis 109 Bulla frontalis 73, 75 77, 137, 138 C Cables 152, 153 Camera systems , video stack/cameras , 153 Cantholysis, inferior Canthotomy, lateral Carcinoma 276 nasopharyngeal 276 squamous cell 126, 276, 278 see also Adenocarcinoma Carotid artery 89, 135, 139 aneurysm 125, 127 occlusion 128 Catarrh Cavernous sinus lesions 270, 271 Cellulitis, periorbital 18, 20, 175 Cerebrospinal fluid leak see CSF leak Chemokines, rhinitis and 280 Children 17 18, asthma Choanal atresia 45, indications for surgery 228 surgical anatomy 228 surgical technique bilateral atresia 228, 229 unilateral atresia 228, 230 useful instruments 230 Chondroma 118, 119, 267 Chordoma 128, 227, Ciliary dysfunction 24, 25, 30 Clivus lesions 270 Complications , adhesions 184, 290 anosmia bleeding anterior ethmoid artery perioperative postoperative , 192, 290 sphenopalatine artery 171 crusting , 188, 192 CSF leak management 180 epiphora 184, 185 external incision 146 fat herniation frontal recess stenosis 186, 187 incidence 146 infection 147, 187 inverted papilloma medial rectus damage 183 nasal obstruction 193 optic nerve lesion 183 orbital complications 146, 147, , osteitis 147, 187, 188 pain 188, 193 patient information 285, 288, 290

2 297 periorbital emphysema 185 recurrent polyposis 147 sinusitis 288 visual complications 147, 177, 178, Computed tomography (CT) parameters points to mention on request 129 preoperative CT checklist radiation exposure 124 radiograph screen 154 when to request 122 see also Computer-aided surgery Computer-aided surgery accuracy 166 advantages and disadvantages 164 economic factors image display 166, 167 localization methods 166 modeling 164 operative time 167 optic function monitoring 168 positioning 164 preoperative work-up 164 real-time 168 registration teaching 168 Concha bullosa , 112 Consent issues , advice about flying complications time off work 145 Craniotomy 239, 251 Cribriform plate , benign tumor management defect repair 245, 246, 247 Crista ethmoidalis Crusting 28, 29, , 188, 192 following full-thickness loss of mucosa 38, 39 CSF leak 47, 146, as perioperative complication , management 180 diagnosis goals of surgery 46 posttraumatic 242 see also Skull base defect Curettes Cystic fibrosis 18, 20 Cytokines, rhinitis and 280 D Dacryocystitis 194 Dacryocystorhinostomy (DCR) 44 46, assessment common canalicular pathology 202 indications laser DCR advantages and disadvantages 201 revision DCR 202 stents 201 surgical anatomy 195 surgical technique alternative techniques 201 principles 201 useful instruments 202 Debridement 191, 192 Dental infection 15, 29 Dermoid 102 Diagnosis 1 4 confirmation examination outpatient examination focus on patient s main complaint 4 history investigations optimization treatment response and 32 see also Endoscopy Diathermy 162, 172 anterior ethmoid artery 208, 209 sphenopalatine artery Digital subtraction angiography (DSA) 128 Diplopia 147 Douching 33 patient information 286 postoperative care , 193 Drills Dural defect repair 46 Dysthyroid eye disease 47, E Ecchymosis 174 Edema 2, 28, 31, 125 middle turbinate 116 uvula 24, 25 Emphysema, periorbital 185 Encephalocele 241, 246, classification 251, 252 definition 251 indications for surgery 251 surgical anatomy 251, 252 surgical technique 253 alternative techniques Endoscopes 154, 155 Endoscopy evidence of mucosal disease outpatient examination Enophthalmos 134, 178 Eosinophilia 25 Epiphora 184, 185, Epistaxis 45, 207 recurrent 128 Ethmoid artery, anterior see Anterior ethmoid artery Ethmoid sinus 66 defect repair 246, posterior 88 89, 94, 108 Ethmoidal air cells 66, sphenoethmoidal 88, 89 Ethmoidectomy partial anterior anatomy 66 indications 65 surgical technique right 13 see also Frontoethmoidectomy; Frontosphenoethmoidectomy; Sphenoethmoidectomy Ethmoiditis 22 Eustachian tube orifice 107 Expectations see Patient s expectations External incision 146 F Facial pain 11, 26 27, 188 Facial swelling 29 Fascia 245 Fat herniation Fluorescein lumbar puncture Flying, advice about 145 Fontanelles, accessory 51 Forceps 157, Fovea ethmoidalis , 207 benign tumor management Freer s elevator 159, 160 Frontal recess 71 78, 85, 109, stenosis 186, 187, 212, 214 see also Frontal sinus; Frontoethmoidectomy Frontal sinus agenesis 78 benign tumor management 269 defect repair , 249 drainage procedure contraindications 210 indications 209 surgical anatomy surgical technique useful instruments see also Frontal recess Frontal sinusotomy type I 69, 70 type II 70 type III 70 Frontoethmoidectomy anatomy definition 69 indications surgical technique alternative techniques useful instruments 87 Frontosphenoethmoidectomy anatomy 100 definition 98 indications surgical technique Fungal rhinosinusitis management 35 see also Aspergillosis

3 298 G Gene therapy 281 General anesthesia technique Giraffe forceps 161 Glioma, sinonasal 125 Globus pharyngeus 24 Granuloma, pyogenic 116, 117, 261, 263 H Hajek Kofler (rotating) punch Haller cell 66, 67 Hasner s valve 109, 110, 195 localization 196 Hemangioma Hemangiopericytoma 271 Hematological parameters 133 Hemorrhage see Bleeding Hereditary hemorrhagic telangiectasia (HHT) 120 Heuwieser antrum grasping forceps 160, 161 Hiatus semilunaris 53, 109 House dust mite control 287 Hyposmia 102 I Immune status Immunodeficiency 30, 130 Immunoglobulin E, rhinitis and 280 Immunological investigations Immunotherapy 282 Infection dental 15, 29 following surgery 147, 187 see also specific infections Inferior cantholysis Inferior turbinate 107 hypertrophied 116 Inflammation in rhinitis 280 therapeutic strategies 281 Informed consent see Consent issues Infundibulotomy 50 63, 65 anatomy definition 50 indications 51 surgical technique alternative techniques useful instruments 63 Instruments see also specific procedures Interdisciplinary cooperation 128 Inverted papilloma see Papilloma, inverted Ipratropium bromide, allergic rhinitis treatment 32, 33, 288 Itraconazole 15, 35, 191 K Kartagener syndrome 30 Kerrison antrum punch 159 Kuhn Bolger curette Kuhn Bolger forceps 161 L Lacrimal cells 66 Lacrimal fossa Lacrimal sac 195, 196 endoscopic localization Lacrimal system 195 Lamella lateralis defect repair 245 Lamina papyracea , , 223 Langerhans cell histiocytosis 267 Laser dacryocystorhinostomy (DCR) advantages and disadvantages 201 Lateral canthotomy Lateral rhinotomy 232, 235 Lighting 154 Local anesthesia 148 Lower respiratory tract problems Lymphoma 43, 119 M Macroadenoma 236 Magnetic resonance imaging (MRI) indications for 125 MR angiography (MRA) see also Computer-aided surgery Malignant tumors see Tumors Maxillary sinus accessory ostium , anterior to uncinate process 114, 115 in posterior fontanelle 116 benign tumor management 270 hypoplasia 137 mucoceles 257 see also Medial maxillectomy Maxillary sinusitis 15 Maxillary sinusotomy type I 50, 51, type II 50, 51, type III 50, 51, Medial maxillectomy , 258 definition 230 indications 230 surgical anatomy 231 surgical technique useful instruments 232 Medial rectus 223 damage 183 Median frontal sinus drainage see Frontal sinus Medical history review 134 Medical treatment advances allergic rhinitis 32 35, , infective rhinosinusitis 34 35, 288 nasal polyps 35 37, , 280, 289 nonallergic rhinitis novel strategies optimization 5, postoperative 9, 191, 192 review of effect 131 Melanoma amelanotic 44, 119 malignant , 276 Meningocele 125 Meningoencephalocele 125 Middle meatus 109, 110 pus 116, 117 Middle turbinate 113 absence 136, 137 anatomical variations bifid 113 paradoxical 112 polypoidal anterior end 113, 114 edematous 116 surgical management , 186 alternative surgical techniques Mucocele 42, 99, 194 management 146, 202, goals of surgery 42 Mucus production of 12, 24 overproduction 24 secretions 5, 14 Mycetoma 14, 52 Myeloma, multiple N Nasal douching 33 patient information 286 postoperative care , 193 Nasal endoscopy Nasal obstruction as indication for surgery 11 postoperative 193 Nasal packs Nasal polyps 2, 88, associated conditions 289 asymptomatic 19 20, 21 children 18, 20 lamella lateralis 135 medical treatment 35 37, 289 advances 280 review middle turbinate 113, 114 nasal obstruction 11 pain and 27, 28 patient information posterior ethmoid sinuses 108 recurrent 147 surgical treatment 289 complications 290

4 299 symptoms and signs 289 unilateral 289 associated with neoplasia 17 see also Antrochoanal polyp Nasolacrimal duct damage during surgery 146 obstruction 46, Neuroblastoma, olfactory 273, 275 surgical management 274, 275 Neurofibroma 17 Nitric oxide (NO) 280 Nose picking 29 O Olfaction tests 12, 27, 133 Olfactory mucosa 27 preservation of 7, surgical removal 9 excessive 7 Olfactory neuroblastoma 118, 119 Onodi cell 88, 139 Operating room setup for computer-aided surgery 164 for one surgeon for two surgeons 151, 152 Operating table 150 Optic nerve 89, 97, 139, 142 decompression 46, indications surgical technique dehiscent 135 in sphenoid air cell 183, 184 infiltration 126 perioperative damage 183 Orbital complications 146, 147, Orbital decompression 46, 147, , indications 221 surgical anatomy surgical technique useful instruments 225 Orbital fracture 48 Orbital tumor management 270 Osteitis 147, 187, 188 Osteoma 71, Osteomyelitis 220 Ostium, accessory see Accessory ostium Outpatient examination P Pain 11, postoperative 188, 193 Papilloma, inverted 16, 17, 44, 118 as indication for MRI 125 ethmoid sinus 65, 259 frontal sinus 118, 269 management , 260 complications medial maxillectomy , 234 maxillary sinus 270 recurrent 147 Patient consent see Consent issues Patient information , 285 complications 285, 288, 290 douching 286 nasal allergy nasal polyps postoperative advice 289 sinus infection 288 surgery 285 Patient preparation 169 Patient selection disease-oriented symptom-oriented who not to select Patient s expectations 5, 20 21, , 285 Peak flow meter Phosphodiesterase inhibitors 281 Pituitary surgery 46, indications surgical anatomy 236 surgical technique craniotomy/frontal approach 239 external transethmoidectomy approach transbuccal-septal-sphenoid approach 238 transnasal endoscopic approach useful instruments 239 Pituitary tumors Plasmacytoma extramedullary 276 Pleomorphic adenoma 268 Pneumocephalus 242, 248, 249 Pollen avoidance 287 Polyposis see Nasal polyps Post-nasal drip 12 Postoperative course 189 Postoperative management advice for patients 289 in hospital douching , 286 nasal packs medical treatment 9, 191, 192 outpatient visit debridement 191, 192 see also Complications Powered shavers 161, 162 Preoperative condition optimization , 169 Proptosis 47, 134, 147, 178, 221 Pseudomeningocele 128 Pterygopalatine fossa lesions 270, 271 Punches Pyogenic granuloma 116, 117, 261, 263 Q Quality of life issues R Radiograph screen 154 Radiography 121 Retention cyst 110 Retro-orbital hemorrhage 181 Retrobullar recess 66 Rhinitis allergic 2 3, 21, atopy markers 282 children 17 management 32 33, 34, , mucosal changes 30 31, 110 postoperative care 191, 193 skin-prick tests 31, 132 asthma and 29 30, 31, idiopathic 33 34, 116, 280 inflammatory agents in 280 with erythema 2 management novel strategies medicamentosa 33, 34 seasonal 110 see also Rhinosinusitis Rhinoforce Stammberger antrum punch 158 Rhinorrhea anterior 12 posterior 12 Rhinosinusitis 116 chronic infective 12, 24 classification 1 diagnosis 1 medical management with polyposis nasal obstruction and pain and pressure pathology 3 pediatric 17 18, quality of life issues goals of see also Rhinitis; Sinusitis Rhinostomy see Dacryocystorhinostomy (DCR) Rhinotomy, lateral 232, 235 S Saccharin clearance test 132 Sarcoidosis 31, 116, 118, 194 Schwannoma 265 Septal deviation 24 Shavers 161, 162 Sickle knife 159, 160 Sinusitis associated causes 288 complications 288 management 288

5 300 Sinusitis maxillary 117 secondary to dental disease 15 patient information 288 symptoms 288 see also Rhinosinusitis Sinusotomy see Frontal sinusotomy; Maxillary sinusotomy; Sphenoid sinusotomy Skin-prick tests 31, 132 Skull base defect 179, 180 diagnosis management 46, 180, indications 240 modifications and alternatives 251 surgical anatomy surgical technique cribriform plate defect 245, 246, 247 ethmoid roof 246, frontal sinus , 249 graft materials 245 lamella lateralis packing and aftercare sphenoid sinus 247, 250 see also CSF leak Skull base tumor management benign lesions malignant tumors Smell, sense of indications for surgery 11 loss of 26, 28 postoperative preservation of 8, 102, turbinate management , screening test 12, 27, 133 steroid treatment effects 5 Sneezing Snoring 24, 25 Sodium cromoglycate, allergic rhinitis treatment 32, 288 Sphenoethmoid recess Sphenoethmoidal air cell 88, 89, 139, 141 optic nerve exposure 183, 184 Sphenoethmoidectomy 40, anatomy 88 definition 87 indications 88 surgical technique alternative techniques useful instruments 97 see also Frontosphenoethmoidectomy Sphenoid ostium 108 Sphenoid septum 139, 141 Sphenoid sinus 88, 89, 93 94, benign tumor management 270 CSF leak 180 defect repair 247, 250 Sphenoid sinusotomy 87, 88, 100 anatomy 100 indications 100 surgical technique type I 100 type II 100, 101 type III 100, 102 Sphenopalatine artery 172, 203 anatomy management indications 203 surgical technique useful instruments 207 perioperative bleeding 171, 172 Sphenopalatine foramen 203, 204 Squamous cell carcinoma 126, 276, 278 Stammberger cutting mushroom punch 159 Stammberger side-biting antrum punch forceps 63, 64, , 161 Stents frontal sinus 218 in dacryocystorhinostomy 201 Steroid treatment 5, 6, nasal allergy 287 postoperative 191, 192 preoperative review of effects 132 rhinitis rhinosinusitis 35 with polyposis side effects 37 Suckers 155, 156 olive-ended 155 Superior turbinate management surgical technique alternative surgical technique Supraorbital cells 73 76, 77, 181 Surgeon s seat 150 Surgical hints Surgical training 284 Swinging flashlight test T Telangiectasia 120 Teleradiology 282 Tension-type headache 131 Teratoma 268 Terminal recess 71, Through-cutting instruments 157, 158 Time off work 145 Timing of surgery Tissue removal, excessive 6 8 Training 284 Tumors 17, 42 44, benign lesion management access for biopsies 272 postoperative monitoring 272 role of endonasal surgery goals of surgery 42 malignant tumor management 17, recurrent/residual malignant disease 279 role of endonasal surgery 272 surgical technique 272 pituitary tumors Turbinate hypertrophy 116, 130 see also Inferior turbinate; Middle turbinate; Superior turbinate U Uncinate process 51 54, 109, anatomical relationships 71 74, , 138 anatomical variations paradoxical 114 pneumatized 114, 115 Uncinectomy 50 see also Infundibulotomy Unipolar suction diathermy 162, 172 anterior ethmoid artery 208, 209 sphenopalatine artery United Airways 29 Uvula, edematous 24, 25 V Vasculitis 30 Video stack/cameras , 153 Visual complications 147, 177, 178, Visual problems W Wegener granulomatosis 4, 31, , mucosal changes 4, 29 White-out 179 Z Zurich scissors 159, 160 Zurich Smell-Test 12, 27, 133