CHAPTER 86

Sinus Surgery

Additional images are available at: evolve.elsevier.com/Tighe/instrumentation/

The paranasal sinuses may need drainage improved or may need diseased membranes removed.

The endoscopy approach may be used. The instruments are introduced alongside the scope. Possible equipment and instruments needed for the procedure include a light source and a nasal set. For irrigation, cysto tubing, a bag of normal saline, and suction tubing may be used.

A brief description of the procedure follows:

1. A Vienna speculum may be needed to dilate the nares.

2. The scope is inserted through the nose.

3. An axial suction/irrigator is used for secretions and for visualization.

4. Blakesley-Weil ethmoid forceps are used to enlarge the maxillary sinus ostium.

5. A Coakley antrum curette may also be used to enlarge the maxillary sinus opening.

6. Gruenwald nasal forceps are used to grasp polyps.

7. Struycken nasal forceps are used to cut the polyps.

8. A Stammberger antrum punch may be used to remove diseased tissue.

86-1 A, Left to right: pediatric and small nasal Blakesley-Weil forceps: 1 pediatric straight; 1 pediatric 45-degree; 1 45-degree small; and 1 90-degree small. B, Left to right: tips: pediatric and small Blakesley-Weil nasal forceps: 1 pediatric straight; 1 pediatric 45-degree, 1 45-degree small; and 1 90-degree small.

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