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| Hosemann Minimally Invasive Endonasal Sinus Surgery Table of Contents1 Introduction 2 Endonasal sinus surgery - basic principles and approaches 2.1 Surgical aspects of the pathophysiology of chronic sinusitis 2.1.1 Respiratory allergy and chronic sinusitis 2.1.2 Aspirin intolerance and chronic sinusitis 2.2 Principles of endonasal surgery 2.2.1 Indications for endonasal surgery of the paranasal sinuses 2.2.2 Approaches to endonasal surgery in chronic inflammation of the paranasal sinuses 2.2.3 Anatomical principles and significance of mucosal reactions in the CT scans of adults and children 2.3 Preoperative evaluation of the patient 2.3.1 Physical examination and endoscopy 2.3.2 Radiological examination and CT scans 2.3.3 Olfactory testing 2.3.4 Provisions for blood replacement and autologous blood transfusion 2.3.5 Preoperative medical treatment 2.3.6 Ophthalmological examination 2.4. Informing the patient 3 Technique of endoscopic endonasal surgery 3.1 Anesthetic technique and positioning 3.1.1 Local anesthesia 3.1.2 General anesthesia 3.1.3 Positioning 3.2 General points on operating technique, adjunctive measures and duration of operation 3.2.1 Endoscopic ethmoid surgery (anterior-to-posterior technique) 3.2.2 Ethmoid surgery using the suction-irrigation endoscope (posterior-to-anterior technique) 3.2.3 Microscope-assisted ethmoid surgery 3.3 Technical modifications 3.3.1 Operation using the monitor 3.3.2 Surgery with headlight and (suction-irrigation) endoscope 3.3.3 Instruments 3.3.4 Endonasal laser surgery 3.4 Special partial ethmoidectomy procedures, the endonasal pansinus operation 3.5 Maxillary sinus procedures 3.5.1 Endonasal maxillary sinus fenestration 3.5.2 Endonasal maxillary sinus surgery 3.5.3 Choanal polyps 3.6 Endonasal sphenoid sinus surgery 3.7 Revision surgery in chronic sinusitis 4 Results of endonasal sinus surgery for chronic sinusitis 4.1 Subjective results 4.1.1 Subjective results of surgery with a headlight 4.1.2 Subjective results of endoscopic surgery and improvement of individual symptoms 4.2 Objective results in nasal polyposis 4.3 Problems of quality assurance, standardization and documentation of results 4.3.1 Classification of preoperative findings and concomitant factors 4.3.2 Classification and standardization of the surgical treatment 4.3.3 Classification of outcome 5 Results in defined patient groups 5.1 Revision surgery 5.2 Patients with type I allergy 5.3 Patients with bronchial asthma 5.3.1 Rhinological and pneumological results of surgery in asthmatics 5.3.2 Relationship between upper and lower airways 5.4 Patients with aspirin intolerance, "ASA triad" 5.5 Patients with cystic fibrosis 5.6 Patients with dyskinetic cilia syndrome 5.7 Endonasal sinus surgery in children 5.8 Fungal sinusitis 5.9 Other special cases 6. Extended spectrum of endoscopic endonasal surgery 6.1 Epistaxis 6.2 Foreign bodies 6.3 Endonasal surgery of the frontal sinus 6.3.1 Endonasal fenestration of the frontal sinus via the natural access 6.3.2 Extended endoscopic frontal sinus surgery, median drainage acc. to Draf 6.4 Endonasal decompression of the optic nerve 6.5 Endonasal surgery of inflammatory complications 6.6 Endonasal orbit surgery 6.7 Endonasal surgery of the lacrimal drainage system 6.8 Endonasal tumor surgery 6.8.1 Endonasal surgery of benign tumors 6.8.2 Endonasal surgery of malignant tumors 6.8.3 Biopsies and palliative operations 6.9 Endonasal surgery of the skull base 6.10 Endoscopic surgery of choanal atresia 6.11 Other indications 7. Complications, side-effects and sequelae 7.1 Type and incidence of complications 7.1.1 Side-effects, sequelae 7.2 Prevention and management of complications 7.2.1 Prevention 7.2.2 Management of complications 7.3 Medicolegal consequences 7.4 Duration of inpatient care, outpatient surgery? 8 Postoperative care following endoscopic surgery 8.1 Wound healing after paranasal sinus surgery 8.2 Schedule for follow-up investigations and aftercare 8.3 Packing and stents 8.4 Local care of the operative field 8.5 Systemic medication 8.5.1 Corticosteroids 8.5.2 Antibiotics 8.5.3 Other preparations 8.6 Adaptive desensitization 8.7 Diet 9 Technical innovations 9.1 Computer-assisted surgery (CAS); video navigation 9.2 Stereoendoscopy 9.3 Other innovations 10 Summary and prospects References |
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