Microscopic endonasal surgery of nasal and paranasal cavities

Objective To present the experience of our department on microscopic surgery of the nose and sinuses and compare our results with those of other standard approaches. Furthermore we attempt to specify the main indications for the use of the method. Methods During the period between January 1990 and December 2002, the prementioned technique was performed in a total of 250 patients. The preoperative evaluation, surgical technique and postoperative management of all patients are described in detail. Results Most common diagnoses included nasal polyps and chronic rhinosinusitis. The average age of patients was 42 years. Males accounted for 48%. No major postoperative complications were noted. Minor complications such as epistaxis and midfacial pain were observed in 24% of cases. While the majority of patients reported severe symptomatology preoperatively, 91% reported substantial improvement of their clinical condition within 3 months after surgery. Conclusion Microscopic surgery is a technique which can be used alternatively to traditional procedures. It provides an excellent, clear, stereoscopic vision and allows the surgeon to work bimanually. Complications are rare and easily controlled. Our experience favors the use of microscopic technique compared to common endoscopic approaches, especially in cases of nasal polyps and chronic rhinosinusitis.