En-Bloc Uncinate Process Removal in Endoscopic Sinus Surgery Using Dr. Ahila’s Uncinate Dissector: How I Do It.

Uncinectomy is a key and first step in functional endoscopic sinus surgery, as it allows access to the maxillary ostium and ethmoid infundibulum. Incomplete or piecemeal removal of the uncinate process can lead to poor exposure and difficulty in identifying the natural ostium. To describe our technique for complete removal of the uncinate process using Dr. Ahila’s uncinate dissector. We outline a stepwise surgical technique based on our experience in approximately 180 patients with chronic rhinosinusitis, with or without nasal polyposis, treated over a three-year period at a tertiary care centre. The procedure involves controlled dissection of the uncinate process along its attachment to the lateral nasal wall under endoscopic guidance, followed by en-bloc removal using Blakesley forceps after resecting superior and inferior attachments with scissors. In most cases, the uncinate process was removed in a single piece, with consistent early identification of the natural maxillary ostium. The technique required minimal instrumentation and was not associated with major complications such as orbital or nasolacrimal duct injury. This “How I Do It” technique provides a simple and controlled method for uncinectomy. It facilitates en-bloc removal and reliable identification of the maxillary ostium and can be readily adopted in routine endoscopic sinus surgery.