The efficacy of functional endoscopic sinus surgery for the treatment of chronic sinusitis is well established. Two contrasting European techniques were introduced to North America in the 1980s: one includes endoscopic modification of all sinus cavities, with modification of the middle turbinates and the other makes use of minimal opening of the narrow osteomeatal tract at the anterior ethmoid sinus to achieve physiological reversal of sinus disease. These techniques were modified recently by the introduction of power resection techniques and stereotactic computer navigation. After exposure to both original techniques, I developed a middle-ground approach that lies between the extremes of the two European schools. The benefits of this middle-ground multimodal technique include a high success rate, maximal safety, relative ease of learning, and the ability to be performed as an adjunct to any other indicated functional nasal surgery. Since its inception, key features of this technique have included concomitant use of fiberoptic headlight with the endoscopes, partial modification of middle turbinates, and incorporation of 1 week of postoperative middle meatal stenting. These have contributed markedly to rates of success and safety.
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