eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Nasal & Sinus Diseases

Functional Endoscopic Sinus Surgery: Workup

Author: Ankit Patel, MD, Staff Physician, Department of Otolaryngology-Head and Neck Surgery, St Joseph Medical Center, Silver Cross Hospital
Contributor Information and Disclosures

Updated: Mar 6, 2008

Workup

Imaging Studies

  • A paranasal sinus CT scan is often obtained after maximal medical therapy for chronic sinusitis in order to ascertain the contribution of confounding factors.
    • Findings on CT scans after appropriate medical treatment may assist in diagnosing or excluding ostiomeatal disease or chronic sinusitis as the etiology for the patient's problems.
    • In patients with normal findings on CT scans and no change in symptoms after medical treatment, a diagnosis of chronic sinusitis is suspect at best.
  • If surgery is to be performed, careful preoperative review of CT scans is essential for safe and complete performance of endoscopic sinus surgery.
  • Conditions such as intraorbital complications of acute sinusitis (eg, orbital abscess or frontal osteomyelitis with Pott puffy tumor) may require an external approach for complete treatment of disease. In these cases, a careful review of preoperative CT scans or MRI films helps to guide the surgeon.

Diagnostic Procedures

  • To diagnose or exclude chronic sinusitis, a complete head and neck examination, along with anterior rhinoscopy, should be performed. If further nasal examination is required, a full nasal endoscopy should be performed.

More on Functional Endoscopic Sinus Surgery

Overview: Functional Endoscopic Sinus Surgery
Workup: Functional Endoscopic Sinus Surgery
Treatment: Functional Endoscopic Sinus Surgery
Follow-up: Functional Endoscopic Sinus Surgery
References
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Further Reading

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Keywords

functional endoscopic sinus surgery, FESS, chronic sinusitis, recurrent sinusitis, sinus infection, rhinosinusitis, chronic rhinosinusitis, rhinology, CSF leak, CSF rhinorrhea, inverted papilloma, orbital decompression, endoscopic DCR, optic nerve decompression, traumatic indirect optic neuropathy, sinus surgery

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Contributor Information and Disclosures

Author

Ankit Patel, MD, Staff Physician, Department of Otolaryngology-Head and Neck Surgery, St Joseph Medical Center, Silver Cross Hospital
Ankit Patel, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery and American Rhinologic Society
Disclosure: a Salary Employment

Medical Editor

Lanny Garth Close, MD, Chair, Professor, Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons
Lanny Garth Close, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Physicians, American Laryngological Association, American Society for Head and Neck Surgery, and New York Academy of Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Stephen G Batuello, MD, Consulting Staff, Colorado ENT Specialists
Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American Medical Association, and Colorado Medical Society
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Advanced Headache Intervention Consulting fee Consulting; Covidien Corp Consulting fee Consulting

 
 
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