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January 1991

Great Debates in Otolaryngology: Intranasal vs Endoscopic Ethmoidectomy

Author Affiliations

Galveston, Tex

Arch Otolaryngol Head Neck Surg. 1991;117(1):19. doi:10.1001/archotol.1991.01870130025006

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At the recent meeting of the American Academy of Otolaryngology—Head and Neck Surgery, San Diego, Calif, September 1990, William Friedman, MD, Alan Sogg, MD, Steve Schaefer, MD, and James Stankiewicz, MD, presented a panel discussion, moderated by Mark Maslan, MD, on their experience with functional endoscopic and nonendoscopic intranasal ethmoidectomy. Panel members were in agreement that both types of procedures are indicated in certain situations, and that each has inherent advantages and disadvantages.

Stankiewicz and Schaefer stated that functional endoscopic sinus surgery attacks the origin of the patient's problem in the osteomeatal complex area and is inherently less destructive than the intranasal ethmoidectomy. Among the other advantages of the endoscopic approach and direct visualization, ability to operate under local anesthesia, and access to all sinuses, including the frontal recess, which can be difficult to reach with the intranasal approach.

Disadvantages of the endoscopic approach include the following: expense of the

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