"L" shape technique for endoscopic sinus surgery: An alternative method

Abstract

Background: Several techniques for performing ethmoidectomy have been reported. We describe a safe, effective and efficient technique during functional endoscopic sinus surgery (FESS). We present text, images and videos to illustrate our preferred technique during an antero-posterior ethmoidectomy and to provide a multimedia tool for educational purpose.

Methods: A description of the technique without prospective or retrospective data is reported. A complete ethmoidectomy with an L-shape approach is described step-by-step, using the backbiting circular and miniature cutting forceps, with safe exposure of the lamina papyracea (LP) and skull base.

Results: In our hands, the L-shape approach for chronic rhinosinusitis with or without polyposis, performed with punch circular cutting and miniature cutting forceps, allowed for a reliably safe and efficient ethmoidectomy.

Conclusion: The technique described can be added to the armamentarium of the endoscopic sinus surgeon.

Keywords: Chronic rhinosinusitis; Endoscopic sinus surgery; Ethmoid; Ethmoidectomy; FESS; L-shape approach; Lamina papyracea.