Microscopic sinus surgery, transnasal ethmoidectomy and sphenoidectomy.

Intranasal ethmoid surgery has traditionally been a "blind procedure" using monocular vision, the delicate control of instruments being less than optimal. The addition of the operating microscope with a special self-retraining retractor speculum is presented in a series of 87 patients over 7 years, 49 of these having had transethmo-sphenoidectomy. Evaluation, anatomy, technique and results are discussed. Whereas the rate of serious complications is reported at 3% in large series, there were no complications in this series. The results of 181 microscopic antrostomies is also discussed. This technique offers considerable added safety to the patient, more self-confidence to the surgeon with binocular vision and much better control of instruments, and allows a more adequate procedure because of less fear of dreaded complications.