title: Revision Functional Endoscopic Sinus Surgery.
abstract: Refractory chronic rhinosinusitis can be challenging to treat. Initial treatment focuses on medical and nonsurgical treatments. If these treatments fail, revision endoscopic sinus surgery is an option. A plan for revision surgery must address anatomic factors contributing to recurrence. Preoperative imaging and sinonasal endoscopy are systematically reviewed; areas of disease and "danger" zones are identified. Traditional anatomic landmarks are often obscured or absent; thus, a set of consistent landmarks (unchanged despite prior surgery) are used to navigate the revision endoscopic sinus surgery. Wide sinusotomies permit visualization and access to disease intraoperatively. Large sinus openings also facilitate post-operative debridements in clinic, endoscopic disease monitoring, and topical sinus therapy.
authors.affiliation: Department of Otolaryngology, University of Miami, Miller School of Medicine, 1120 Northwest 14th Street, 5th Floor, Miami, FL 33136, USA. Electronic address: Cxl861@miami.edu.
authors.forename: Corinna G
authors.initials: CG
authors.lastname: Levine
authors.affiliation: American Rhinologic Society, Rhinology and Endoscopic Skull Base Program, Department of Otolaryngology, Head & Neck Surgery, University of Miami, Miller School of Medicine, Clinical Research Building, 5th Floor, 1120 Northwest 14th Street, Miami, FL 33136, USA.
authors.forename: Roy R
authors.initials: RR
authors.lastname: Casiano
mesh_terms: D002908:Chronic Disease; D006801:Humans; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D010256:Paranasal Sinuses / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation / Q000379:methods*; D012220:Rhinitis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D012852:Sinusitis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Chronic rhinosinusitis; Neo-osteogenesis; Polyps; Refractory rhinosinusitis; Revision FESS; Scarring; Stenosis