SURGICAL-MANAGEMENT OF RHINOSINUSITIS

Rhinosinusitis, an inflammatory disease involving the nasal cavity and paranasal sinuses, affects millions of individuals and its costs run into the billions of dollars. The development of rigid nasal telescope s has revolutionized the diagnosis and treatment of this disease. Rece nt endoscopic evaluations have identified certain key areas within the nasal cavity that, when inflamed, lead to sinus ostial obstruction an d subsequent sinus infection. The telescope's increased visualization capabilities permits the physician to better target and individualize patient care and the techniques that have grown out of this new tool a llow for a more physiologic approach to surgical treatment. The pathop hysiology of rhinosinusitis and its medical treatments are considered. Indications for surgical management are reviewed, with attention to n ontraditional or extended applications of endoscopic techniques. Preop erative evaluation, including nasal endoscopy and radiographic imaging , as well as surgical technique and postoperative care are discussed. Evaluation of outcomes from surgical treatment in appropriately select ed patients have demonstrated the success of this technique.