PAKISTAN ARMED FORCES
MEDICAL JOURNAL (Category Y)

A Journal of Army Medical & Dental Corps

Being published since 1956

ISSN (online) 2411-8842
ISSN (print) 0030-9648

VOL 64, No. 4, AUGUST 2018

EXTENDED APPLICATION OF FUNCTIONAL ENDOSCOPIC SINUS SURGERY IN OPHTHALMOLOGY AND NEUROSURGERY

Maqbool Raza

Abstract

 

Objective: To establish the importance of functional endoscopic sinus surgery (FESS) as extended application to avoidmore conventional and radical procedure for orbit and skull base. 
Study Design: Retrospective study. 
Place and Duration of Study: This study was carried out at Military Hospital and CMH Rawalpinidi, and CMH Quetta from Sep 2013 to Sep 2017.
Material and Methods: Fifty-six patients were included in this study with inflammatory disease, tumour of skull base and orbit. Patients were referred by Ophthalmologists, Neuro surgeons, pediatricianand few came directly to ENT department. Different endoscopic techniques, endoscopic orbital decompression, trans-sphenoidal endoscopic approach, endoscopic CSF repair were adopted to treat these cases. Angled endoscopes from 0,30,70 degrees were used along with microdebrider and drill (powered instruments)for extended application of FESS. Outcomewas successful disease removal with endoscopes. Data was analysed by data triangulation method, involving ophthalmologists and neuro surgeons. 
Results: Results were achieved in the form of complete endoscopic removal of inflammatory pathology in 32 cases, fungal disease in 12 cases, tumour pathology in 2 cases and cyst removal in one case. Revision surgery was done in 5 cases. Success rate of endoscopic surgery was 91.7% as primary treatment and 100% with revision surgery. 
Conclusion: Endoscopic sinus surgery (FESS) was found 91.7% successful as primary treatment and 100% with revision surgeryof orbit and skull base diseases.

Keywords : Endoscopic sinus surgery, Extended applications, Orbit, Powered instruments, Skull base.



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