Functional endoscopic sinus surgery

The theory behind functional endoscopic sinus surgery (FESS) is to re-establish drainage from the maxillary, ethmoid, sphenoid, and frontal sinuses. In addition, allowing the ostiomeatal complex to stay patent is an important factor in re-establishing mucociliary clearance from the dependant sinuses. By achieving adequate drainage from the natural ostium, the mucosal disease and subsequent symptoms could become reversible in many cases. Many children who are considered for FESS have comorbidities that include allergies, immune deficiency, ciliary disorders or cystic fibrosis. Medical management should be maximized before FESS. There are multiple methods and techniques described to perform FESS; however, in this manuscript we will describe an anterior to posterior technique used at the University of Miami.