aharkins
New
I have a physician that states he did total ethmoid w/ sphenoid, maxillary and frontal but I don't agree what do you think?
Beginning on the right, the 0° endoscope was inserted. The middle turbinate was visualized and pushed medially using a Freer elevator. The mucosa of the uncinate process and ethmoid bulla were injected with 1% lidocaine with 1:100,000 epinephrine. Using a Lusk ostium seeker, the natural ostium of the maxillary sinus was identified and the uncinate process retracted anteriorly. Using a backbiting forceps, the uncinate was incised inferiorly. In doing so, the maxillary antrum was entered and a wide antrostomy created. The uncinate was completely removed using the backbiting forcep and the microdebrider unit. The ethmoid bulla was entered using the Tru-Cut Blakesley forceps. The ethmoid air cells were dissected using the Tru-Cut Blakesley forceps and the microdebrider unit. Dissecting inferiorly and medially, the sphenoid ostium was opened using the sphenoid punch. Landmarks were confirmed throughout the dissection with the image guidance unit to assure complete removal of the sinus cells.
Using a 45° endoscope, the frontal recess was visualized and the frontal sinus was opened using the frontal sinus punch. The maxillary antrum was visualized using the 45° endoscope. Care was taken to assure that the uncinate had been completely resected.
Moving to the left, the 0° endoscope was inserted. The middle turbinate was visualized and pushed medially using a Freer elevator. The mucosa of the uncinate process and ethmoid bulla were injected with 1% lidocaine with 1:100,000 epinephrine. Using a Lusk ostium seeker, the natural ostium of the maxillary sinus was identified and the uncinate process retracted anteriorly. Using a backbiting forceps, the uncinate was incised inferiorly. In doing so, the maxillary antrum was entered and a wide antrostomy created. The uncinate was completely removed using the backbiting forcep and the microdebrider unit. The ethmoid air cells were removed using the Thru cut forceps and the microdebrider unit. Dissection proceeded posteriorly through the basal lamella into the posterior ethmoid. Landmarks were confirmed throughout the dissection with the image guidance unit to assure complete removal of the sinus cells. Dissecting inferiorly and medially, the natural ostium of the sphenoid was identified. This was widely opened using a sphenoid punch. The ethmoidectomy was completed using the micro debrider unit. The lamina papyracea and skull base were maintained intact.
Using a 45° endoscope, the frontal recess was visualized. Using the frontal sinus punch, the roof of the anterior ethmoid air cells was removed opening the nasofrontal duct. The lumen of the frontal sinus could be widely visualized. The maxillary antrum was visualized and care was taken to assure that the uncinate was completely resected. The middle meatus was then packed with cottonoid pledgets soaked in oxymetazoline solution.
Beginning on the right, the 0° endoscope was inserted. The middle turbinate was visualized and pushed medially using a Freer elevator. The mucosa of the uncinate process and ethmoid bulla were injected with 1% lidocaine with 1:100,000 epinephrine. Using a Lusk ostium seeker, the natural ostium of the maxillary sinus was identified and the uncinate process retracted anteriorly. Using a backbiting forceps, the uncinate was incised inferiorly. In doing so, the maxillary antrum was entered and a wide antrostomy created. The uncinate was completely removed using the backbiting forcep and the microdebrider unit. The ethmoid bulla was entered using the Tru-Cut Blakesley forceps. The ethmoid air cells were dissected using the Tru-Cut Blakesley forceps and the microdebrider unit. Dissecting inferiorly and medially, the sphenoid ostium was opened using the sphenoid punch. Landmarks were confirmed throughout the dissection with the image guidance unit to assure complete removal of the sinus cells.
Using a 45° endoscope, the frontal recess was visualized and the frontal sinus was opened using the frontal sinus punch. The maxillary antrum was visualized using the 45° endoscope. Care was taken to assure that the uncinate had been completely resected.
Moving to the left, the 0° endoscope was inserted. The middle turbinate was visualized and pushed medially using a Freer elevator. The mucosa of the uncinate process and ethmoid bulla were injected with 1% lidocaine with 1:100,000 epinephrine. Using a Lusk ostium seeker, the natural ostium of the maxillary sinus was identified and the uncinate process retracted anteriorly. Using a backbiting forceps, the uncinate was incised inferiorly. In doing so, the maxillary antrum was entered and a wide antrostomy created. The uncinate was completely removed using the backbiting forcep and the microdebrider unit. The ethmoid air cells were removed using the Thru cut forceps and the microdebrider unit. Dissection proceeded posteriorly through the basal lamella into the posterior ethmoid. Landmarks were confirmed throughout the dissection with the image guidance unit to assure complete removal of the sinus cells. Dissecting inferiorly and medially, the natural ostium of the sphenoid was identified. This was widely opened using a sphenoid punch. The ethmoidectomy was completed using the micro debrider unit. The lamina papyracea and skull base were maintained intact.
Using a 45° endoscope, the frontal recess was visualized. Using the frontal sinus punch, the roof of the anterior ethmoid air cells was removed opening the nasofrontal duct. The lumen of the frontal sinus could be widely visualized. The maxillary antrum was visualized and care was taken to assure that the uncinate was completely resected. The middle meatus was then packed with cottonoid pledgets soaked in oxymetazoline solution.