OtoRhinoLaryngology Portal

The Leading Online Gallery of Otolaryngology and Head & Neck Surgery Specialty

OtoRhinoLaryngology Portal Video Collections @

YouTube & MEDtube

Maxillary Antrum Views:Intraoperative

Left antrum seen via meatotomy. 

    

                     Pre-suction                                        Post-suction

M- Mucopus, arrow- infraorbital nerve

 

Trans-ostial view of right maxillary antrum by using 30 degree rigid endoscope facing laterally in a patient who had nasal polyps.  Punctate submucosal patechial haemorrhagic spots noted without other mucosal changes.  The sinus ostium

was naturally enlarged and meatotomy was unnecessary. 

[Stars- posterior edge of maxillary sinus ostium,

arrow- infraorbital nerve traversing maxillary bone]

 

Watch video of infraorbital nerve course in the maxillary sinus @ YouTube

Inferior Meatal Antrostomy

This figure shows a wide inferior meatal antrostomy opening.  It was previously a popular surgical management of chronic maxillary sinusitis.  However, the normal ciliary direction is towards the natural sinus ostium which is sited higher.

 

Dotted circle- antrostomy opening, IT- inferior turbinate,

MT- middle turbinate, S- nasal septum, N- nasopharynx.

 

 

Video clip of left inferior meatus antrostomy.

 

Endoscopic findings of right inferior meatal antrostomy and turbinectomy

which was performed for chronic sinusitis with nasal polyposis. 

[Stars- antral polyps, arrow- nasolacrimal duct openng, S- nasal septum, MT- middle turbinate, N- nasopharynx]

 

Watch video of inferior meatal antrostomy with antral polyps @ YouTube

Frontal Sinus

Left figure shows transillumination of frontal sinus

with the endoscope light intoduced into the nasal cavity leading to its ostium. 

Right figure shows the frontal sinus view intraoperatively

with stars indicate midline.

 

Watch video of frontal sinus endoscopy and transillumination @ YouTube

Concha Bullosa Surgery

Figures depict surgery of left concha bullosa.  Its lateral-half was excised which showed hyperplastic mucosa (+) as it was involved by chronic infection.  Uncinectomy, middle meatotomy, and ethmoidectomy was performed as well as part of the conventional functional endoscopic sinus surgery.  [S - nasal septum, MT - middle turbinate, E - uncapped ethmoid sinus air cells, arrow - middle meatotomy]

Middle Meatus Appearance after Functional Endoscopic Sinus Surgery (FESS)

This image shows the appearance of the left middle meatus in a patient

who had functional endoscopic sinus surgery performed. 

The ethmoids air cells were uncapped and the mucosa had healed. 

Frontal recess heading towards the sinus ostium can be seen superiorly.

 

Watch video of nasal cavity appearance after FESS @ YouTube

Middle Turbinate Adhesion Post-FESS

This image shows an adhesion in the right middle meatus involving middle turbinate and lateral nasal wall complicating sinusitis management.  It was left alone as there was no significant effect caused.

 Another example of mucosal synechiae (+).  

[S -nasal septum. MT - middle turbinate]

A similar synechiae on left side.

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