Secure endoscopic sinus surgery as an adjunct to functional nasal surgery.

The efficacy of functional endoscopic sinus surgery for the treatment of chronic sinusitis is well established. Two contrasting European techniques are currently in use: that espoused by Wigand, which includes endoscopic exenteration of all the sinus cavities with removal of the middle turbinates, and that developed by Messerklinger, who practices minimal opening of the narrow osteomeatal tract at the anterior ethmoidal sinus to achieve physiological reversal of sinus disease. After exposure to both techniques, one of us (P.H.T.) developed a middle-ground approach that lies between the extremes of the two European schools. The benefits of this middle-ground technique include a high success rate, maximal safety, relative ease of learning, and its ability to be performed as an adjunct to any other indicated functional nasal surgery.