AN ANATOMIC APPROACH TO ENDOSCOPIC INTRANASAL ETHMOIDECTOMY

Objectives: Ton develop an anatomic and functionally based approach to endoscopic intranasal ethmoidectomy. to develop such an approach usin g the salient features of the anterior to posterior (AP) and posterior to anterior (PA) intranasal sinus operations. To assess the safety of this form of ethmoidectomy in a patient population. Study Design: Ret rospective chart review of patients undergoing ethmoidectomy by author or by residents under his direct supervision. Setting: University tea ching hospital. In the 509 patients meeting study criteria, 168 anteri or ethmoidectomies, 586 total ethmoidectomies, 264 sphenoidotomies, 29 0 frontal sinusotomies, and 838 antrostomies were performed between Ap ril 1992 and August 1997. Results: A complication rate of 0.98% and re vision rate 2.9% were observed. Conclusions: Combining an AP approach to conserve sinus anatomy with a PA approach to avoid surgery directed toward the skull base provides a functional and safe procedure as dem onstrated by the reported results.