Disadvantages of minimal techniques for surgical management of chronic rhinosinusitis.
OBJECTIVE
Controversy exists over the best surgical treatment for chronic rhinosinusitis. Minimally invasive sinus technique is a conservative approach in which simple ventilation of the lower sinuses is thought to cure even severe pathologic disease. Recent articles have suggested short-term subjective efficacy. Before this procedure is validated, we must compare it with the current gold standard: functional endoscopic sinus surgery.


RESULTS
Functional endoscopic sinus surgery has been the standard surgical technique for many years and has demonstrated true short- and long-term subjective and objective efficacy. With improved understanding of the pathogenesis of chronic rhinosinusitis, it appears that much of its success lies in its ability to fully remove diseased bony partitions and to remove areas of chronic inflammation and assist in the medical management of chronic rhinosinusitis.


CONCLUSIONS
Given our current knowledge of chronic rhinosinusitis, functional endoscopic sinus surgery is the approach that has shown great success and makes the most sense when surgery is truly required in the management of this disease process.
Chiu
Alexander G
AG
Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia 19104, USA. alexander.chiu@uphs.upenn.edu
Kennedy
David W
DW
D002908:Chronic Disease; D004724:Endoscopy / Q000009:adverse effects*; D006801:Humans; D010256:Paranasal Sinuses / Q000601:surgery*; D011183:Postoperative Complications; D012220:Rhinitis / Q000601:surgery*; D012852:Sinusitis / Q000601:surgery*; D016896:Treatment Outcome