Development of Systematic Endoscopic Microsurgical Procedures in Endonasal Sinus Surgery

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Endonasal sinus surgery became increasingly important procedure in rhinological practice because it is the most appropriate therapeutic method for chronic sinusitis. This procedure, However, is ranked as a highly difficult surgery which needs a special skill.In this project, the following ersearch and investigations were made to establish systematic method in application of endoscopic sinus surgery for chronic sinusitis. (1) The healing process of chronic sinusitis after endonasal sinus surgery: Was investigated in our series of 40 cases (65 sides). The result showed that 43% were completely cured, maintaining both structure and function, and only a few cases showed no remission.(2) Introduction of endoscopes in surgery: Was investigated to obtain the most acceptable and safe employment. The most appropriate endoscope was found to be the rigid telescope of 4mm in diameter with 80 degree visual angle. Gthe surgeon should compromise with it to disturb surgical manipulation occasionally.(3) Introduction of televising system: Is much effective for education. The most efficient make was the Circon CCD TV camera with its beamsplitter.(4) Special surgical equipments: Were designed to perform microsugical proceddures which is characterized to preserve mucosa appropriately.(5) Computer-aided thiee-dimensional reconstrution of the sinuses: Was found to be efficient to establish the spatial orientation in the individual sinuses.(6) Precautionary surgical measures in endonasal sinus surgery: Were invastigated to prevent delayed healing and postoperatve obstruction of the opening of the sinuses.