Image Guidance in Endoscopic Sinonasal Surgery

Messerklinger revolutionized the management of chronic rhinosinusitis by enhancing the understanding of drainage pathways of the sinuses and how they are affected by anatomical variations. This subsequently led to the development of functional endoscopic sinus surgery (FESS) in the late 1980s as a modality to better treat chronic inflammation of the sinonasal cavity by aiming to restore the natural mucociliary drainage and ventilation of the sinuses by resecting localized disease. Computed tomography (CT) imaging of the paranasal sinuses is an essential prerequisite before surgery as it delineates the presence and extent of disease in addition to highlighting important anatomical variations that could potentially predispose to complications.