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An anatomic approach to endoscopic intranasal ethmoidectomy

Objectives: To develop an anatomic and functionally based approach to endoscopic intranasal ethmoidectomy. To develop such an approach using 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: Retrospective chart review of patients undergoing ethmoidectomy by author or by residents under his direct supervision. Setting: University teaching hospital. In the 509 patients meeting study criteria, 168 anterior ethmoidectomies, 586 total ethmoidectomies, 264 sphenoidotomies, 290 frontal sinusotomies, and 838 antrostomies were performed between April 1992 and August 1997. Results: A complication rate of 0.98% and revision 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 demonstrated by the reported results. Laryngoscope, 108:1628–1634, 1998