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Frontal Sinus

Functional Endoscopic Sinus Surgery


1.Local anesthesia and decongestion for the elevation of the axillary flap. 2.The incision along the inferior border of the flap.
3.Elevation of the flap. 4.Releasing incision at the area of the axilla and removal of the upper end of the uncinate process.
5.A large part of the anterior wall of the agger nasi cell is already thinned. 6.Removal of the anterior agger nasi wall with a curette.
7.Complete removal of the anterior wall with a Kerrison punch. 8.Removal of the mucosa of the agger nasi cell.
9.Dissecting along the medial and posterior wall of the agger nasi. 10.Removal of the posterior wall of the agger nasi.
11.Removal of the anterior wall of the suprabullar cell. 12.Grasping the mucosa of the suprabullar cell.
13.Opening the suprabullar cell. 14.Removing the nasal beak with a frontal punch.
15.Change to a 45 endoscope. View of the frontal sinus. 16.View of the frontal sinus after further enlargement of the ostium. Note the characteristic bone lamina at the roof of the sinus.

17.Repositioning of the axillary flap.