Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-10T16:07:02.915Z Has data issue: false hasContentIssue false
  • English
  • Français

The ‘swing-door’ technique for uncinectomy in endoscopic sinus surgery

Published online by Cambridge University Press:  29 June 2007

P. J. Wormald  and
Mike McDonogh
P. J. Wormald*
Affiliation:
Department of Otolaryngology, Chinese University of Hong Kong, Pretoria, South Africa.
Mike McDonogh
Affiliation:
Department of Otolaryngology, Hong Kong and Waterkloof, Pretoria, South Africa.
*
Address for correspondence: P. J. Wormald, Division of Surgery, Queen Elizabeth Hospital, 28 Woodville Road, Woodville South 5011, South Australia.
Get access Rights & Permissions [Opens in a new window]

Abstract

Uncinectomy is an important step in endoscopic sinus surgery. The traditional method of performing uncinectomy has the risk of penetration of the lamina papyracea with orbital fat exposure. If the orbital penetration is not recognized, major complications may follow. In this study the authors used historical consecutive controls to compare the incidence of orbital penetration, identification of the natural ostium and lacrimal apparatus injury by the traditional surgical technique and a new technique of uncinectomy. Six hundred and thirty-six uncinectomies have been performed using the ‘swing-door’ technique. The 636 uncinectomies performed prior to changing techniques were used as historical controls. The incidence of orbital penetration (six compared to 0; p<0.05) and ostium non-identification (42 not identified as compared to 0; p<0.001) was significantly less with the new technique. One lacrimal injury occurred with the ‘swing-door’ technique compared to zero with the standard technique (p>0.05). The techniques are described and the complications discussed. The authors recommend this technique as it is easy to learn, allows removal of the uncinate flush with the lateral nasal wall and allows easy identification of the natural ostium of the maxillary sinus.

Keywords

Surgery, operativeEndoscopyParanasal sinuses
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 6 , June 1998 , pp. 547 - 551
Copyright
Copyright © JLO (1984) Limited 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Clerico, D., Kennedy, D., Henick, D. (1996) Functional endoscopic sinus surgery. In Diseases of the Sinuses. (Gershwin, M., Incaudo, G., eds.) Humana Press Totowa, New Jersey, pp 547–561.Google Scholar
Duncavage, J. (1995) Maxillary sinus revision surgery. In Advanced Endoscopic Sinus Surgery. (Stankiewicz, J., ed.) Mosby, St Louis, pp 7–11.Google Scholar
Kinsella, J., Calhaoun, K., Bradfield, J., Hokanson, J., Bailey, B. (1995) Complications of endoscopic sinus surgery in a residency program. Laryngoscope 105: 1029–1032.CrossRefGoogle Scholar
Levine, H. (1990) Functional endoscopic sinus surgery: evaluation, surgery, and follow-up of 250 patients. Laryngoscope 100: 79–84.CrossRefGoogle ScholarPubMed
Mackay, I. S. (1992) Functional endoscopic sinus surgery. Clinical Otolaryngology 17: 1–2.Google Scholar
Messerklinger, W. (1978) Endoscopy of the Nose. Urban and Schwarzenberg, Munich. pp 52–54.Google Scholar
Rice, D. (1995) Endoscopic sinus surgery. In The Sinuses (Donald, P., Gluckman, J., Rice, D., eds.) Raven Press, New York, pp 255–270.Google Scholar
Schaefer, S. (1986) Endoscopic total sphenoethmoidectomy. Otolaryngologic Clinics of North America 22: 727–732.Google Scholar
Schaefer, S., Manning, S., Close, L. (1989) Endoscopic paranasal sinus surgery: Indications and considerations. Laryngoscope 99: 1–5.CrossRefGoogle ScholarPubMed
Schaitkin, B., May, M. (1995) Revision endoscopic sinus surgery. In Advanced Endoscopic Sinus Surgery. (Stankiewicz, J., ed.) Mosby, St Louis, pp 1–6.Google Scholar
Setcliffe, R. (1996) Minimally invasive sinus surgery. The rationale and the technique. Otolaryngologic Clinics of North America 29: 115–129.Google Scholar
Serdahl, C., Berris, C., Chole, R. (1990) Nasolacrimal duct obstruction after endoscopic sinus surgery. Archives of Ophthalmology 108: 391–392.Google Scholar
Stammberger, H. (1986) Endoscopic endonasal surgery Concepts in treatment of recurring rhinosinusitis. Otolaryngology and Head and Neck Surgery 94: 143–156.CrossRefGoogle ScholarPubMed
Stankiewicz, J. A. (1987) Complications of endoscopic intranasal ethmoidectomy. Laryngoscope 97: 1270–1273.CrossRefGoogle ScholarPubMed
Stankiewicz, J. A. (1989) Complications in endoscopic intranasal ethmoidectomy: an update. Laryngoscope 99: 686–690.CrossRefGoogle ScholarPubMed
Vleming, M., Middelweerd, R., de Vries, N. (1992) Complications of endoscopic sinus surgery. Archives of Otolaryngology – Head and Neck Surgery 118: 617–623.Google Scholar
Wake, M., Takeno, S., Hawke, M. (1994) The uncinate process: A histological and morphological study. Laryngoscope 104: 364–369.Google Scholar