SAFE AND EFFECTIVE INFUNDIBULOTOMY TECHNIQUE

The ostiomeatal complex has been identified as an important anatomic r egion in the pathogenesis of sinusitis. Functional endoscopic techniqu es rely on removal of mucosal disease from this site to improve draina ge and aeration. Structural variations and the use of a sharp blade to create the infundibulotomy can result in inadvertent Injury to the or bit. To avoid orbital penetration we perform the infundibulotomy with a curved, blunt dental elevator and displace the unclnate with its med ial and lateral mucosa toward the middle turbinate. This stretches the infundibulum to reveal the maxillary ostium at its depth. The remaini ng mucosal attachments of the uncinate process are then incised under direct vision, and the complex is resected, creating an initial wide a ntrostomy. This technique has avoided orbital penetration in 700 cases in patients with early or late stages of mucosal disease.