Basic Functional Endoscopic Sinus Surgery (FESS): A Step-By-Step Guide With Surgical Videos and Illustrations of Anatomical Landmarks in Cadaveric Dissection

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2025-03-25

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We consider four important landmarks in basic FESS. These landmarks are important to gain entry to the maxillary sinus, anterior ethmoid, posterior ethmoid and the sphenoid sinus. Each landmark serves as a gate to a defined space within the paranasal sinuses. This chapter presents an overview to better understand this Gate System. To visualise the different structures of the nose, the nasal cavity is decongested. This can be done with cotton ribbon gauze soaked in Moffat’s solution (1ml adrenaline 1:1000, 2mls 10% cocaine, 4mls 8.4% so-dium bicarbonate, 13mls water/saline) for several minutes. Alternatively, adrenaline 1:1000-soaked cotton ribbon gauze can be used. It is important to pack the middle meatus under endoscopic vision (A).
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