Q.8 Adult Patient: “Me K’hum Tob Mai?” [ Are there solutions? ]

A.8 I don’t know all the answers but I can tell you that sphenoidal sinus surgery is made easier now because of new techniques and equipment. As for frontal sinus surgery, it is still difficult because, inside the nose, the surgeon has to operate at an angle to get up to the frontal sinus.

To operate in a more easy manner, there is an mini external approach; a little facial incision is needed followed by drilling to gain access into the diseased frontal sinus and surgery involves creating or enlarging an outflow tract or a drainage passage from the sinus into the nasal passage/cavity.^10,11

BOTTOM LINES

•  Better communication may prevent misunderstandings between patients and doctors,

•  Misunderstandings and high expectation by patients may lead to unfortunate situations.

REFERENCES

1. Lee JY, Lee SW, Lee JD. Comparison of surgical outcome between primary and revision endoscopic surgery. Am
J Otolaryngol 2008:29:379-84.
2. Moses RL, Cornetta A, Atkins JP Jr, Roth M, Rosen MR, Keene WM. Revision endoscopic sinus surgery: the Thomas Jefferson University Experience. Ear Nose Throat J 1998;190:199-202.
3. Iro H, Mayr S, Wällisch C, Schick B, Wigand ME. Endoscopic sinus surgery: its subjective medium-term
outcome in chronic rhinosinusitis.
4. Garrel R, Gardiner Q, Khudjadze M, Demoly P, Vergnes C, Makeieff M, Guerrier B, Crampette L. Endoscopic surgical treatment of sinunasal polyposis- medium term outcomes (mean follow-up of 5 years). Rhinology
2003;41:91-6.
5. Rowe-Jones JM, Medcalf M, Durham SR, Richards DH, Mackay IS. Functional endoscopic sinus surgery: 5 year follow up and results of a prospective, randomized. stratified, double blind, placebo-controlled study of postoperative fluticazone propionate aqueous nasal spray. Rhinology 2005;43:2-10.
6. Senior b, Kennedy DW, Tanabodee J, Hans Kroger MPH, Hassab M, Lnza D. Long-term results of functional endoscopic sinus surgery. The Laryngoscope 2009;108:151-7.
7. McMains KC, Kountakis SE. Revision functional endoscopic sinus surgery: objective and subjective surgical outcomes. Am J Rhinol 2005;19:344-7.
8. Nitinavakarn B, Thanaviratananich S, Sangsilp N. Anatomical Variations of the Lateral Nasal Wall and
Paranasal Sinuses: A CT Study for Endoscopic Sinus Surgery (ESS) in Thai Patients. J Med Assoc Thai
2005;88:763-8.
9. Muntarbhorn K. FESS and Revision Endoscopic Sinus Surgery: Personal Experience of Medium-Term and
Long-Term Outcomes. In: Rhinology and Memories, Muntarbhorn K, ed. Bangkok: MT Press, 2010 (in
preparation): pages 16-31.
10. Muntarbhorn K and Thanaviratanich S. Mini-anterior and Combined Frontal Sinusotomy and Drilling of the Nasofrontal Beak. In: Micro-Endoscopic Surgery of The Paranasal Sinuses and The Skull Base, Stamm AC, Draf W, eds. Berlin: Springer, 2000: 279-286.
11. Muntarbhorn K. Mini-anterior Frontal Sinusotomy and Trephination: Questions and Answers. In: Rhinology
and Memories, Muntarbhorn K, ed. Bangkok: MT Press, 2010 (in preparation): pages 32-38.

Some of Dr. Kanit Muntarbhorn’s publications are listed below.

RHINOLOGY PUBLICATIONS AS FIRST AUTHOR

Muntarbhorn K. Functional endoscopic sinus surgery. Ramathibodi Med J 1987;10:171-5.
Muntarbhorn K, Clongsusuek P, Leopairut J. Lateral rhinotomy and its complications. Rhinology 1988;suppl.1:71.
Muntarbhorn K. Conjuctivorhinoductoplasty: a new duct for lacrimal bypass using two flaps and a turbinal graft. Rama Med J 1988;11:153-8.
Muntarbhorn K. Uvulopalatopharyngoplasty for excessive snoring, sleep apnea, and hypertension. Intern Med (Thailand) 1988;4:108-111.
Muntarbhorn K. Functional endoscopic sinus surgery by one otolaryngologist. Abstract book of the 4th ASEAN Otorhinolaryngological Head & Neck congress, Singapore, April 6-9, 1989:225.
Muntarbhorn K. Sublabial midfacial degloving operation and its modification. Abstract book of the 8th Joint Congress of the Asian-Pacific Federations of the International College of Surgeons, Bangkok, 1989:216.
Muntarbhorn K, Clongsusuek P, Jenjitranant J. Conjuctivorhino-ductoplasty: a new lacrimal duct with a
conjunctival flap, a nasal flap, and a turbinal graft. Proceedings of the XIV World Congress of Otolaryngology, Madrid, Spain, 1989:2801-4.