The introduction of Functional Endoscopic Sinus Surgery (FESS) has brought about a change in the management of chronic inflammatory sinus diseases. Nasal endoscopy has increased awareness of the fact that the middle meatus plays a significant role in most sinus diseases. Most inflammations of the ethmoid, maxillary and frontal sinuses arise from this point when swelling and hypertrophy of the mucosa of the ethmoid infundibulum interfere with their natural drainage and ventilation.
This was a study of 30 patients who presented with recurrent sinusitis and failed to improve on conservative treatment. Our aim was to examine by endoscopy the lateral nasal wall in general and the Semilunar hiatus and the infundibulum in particular and at the same time strip off any diseased mucosa found so as to improve the normal drainage and ventilation of the sinuses. In all of them Functional Endoscopic Sinus Surgery (FESS) revealed mucosal changes in the ethmoid infundibulum as an aetiological factor for the recurrent or chronic sinusitis, which had not been detected by the conventional diagnostic techniques. With FESS technique, diseases and lesions of the lateral nasal wall which otherwise might not have been recognized can be identified and consequently treated.