1. Ultrasonic methods are valuable for screening of acute maxillary and frontal sinusitis, 2. Sinoscopy is a simple approach for inspection and further examination of secretions and mucosal specimens, 3. Bacterial specimens are relevant only when taken from the sinuses, 4. Computerized tomography is necessary for an adequate evaluation of the ethmoidal region, 5. Chronic maxillary sinusitis of dental origin should more extensively be looked for, and 6. Examination of the maxillo-nasal ostia may be a valuable diagnostic complement in recurrent infections.
Our method for endonasal sinusectomy under endoscopic control allows us to clarify the patient's status during operation because of the use of local anesthesia. It has the following advantages: 1) as much pathological mucosa as necessary can be removed under endoscopic control as the patient's local condition is being monitored, because bleeding is slight, 2) surgical complications can be prevented, and 3) decreases in the operator's skill cause by farsighted glasses can be compensated for.
Endonasal sinusectomy is a useful method for treating chronic sinusitis. It can be performed safely if the surgeon has good knowledge of the local anatomy. We indicate five areas of potential hazard related to the sinuses, which we hope will be helpful to surgeons in preventing complications during this operation. The use of the endoscope in endonasal sinusectomy allows safe and exact surgery through improved visualization of the operatoin field and identification of the areas of potential hazards.
Laser surgery was applied to chronic sinusitis and hvpertrouhic rhinitis. And following results were obtained: 1) Nd: YAG laser antrosomy using flexible fiberscope was developed successfully for improvement of a blocked natural ostium. 2) Contact Nd: YAG laser surgery was applied to turbinectomy in hypertrophic rhinitis and nasal allergy, and good results were obtained for reducing nasal obstruction. The results suggest that endonasal operations to which laser technique is applied will be fully used as an ambulatory surgery in the future.