The search for more sparing methods of surgical treatment of diseases of the nasal cavity and paranasal sinuses was aimed at minimizing surgical trauma and preserving the normal anatomy of the intranasal structures.

The development of functional endoscopic rhinosurgery is associated with the development of rigid endoscopes. The endoscope is an optical system with a built-in fiberglass light guide, enclosed in a metal sheath. The resulting image can be evaluated directly through the lens or, if there is a video camera, on the monitor screen. At the same time, by increasing the area under study, it is possible to identify the most minimal changes, simply by bringing the end of the endoscope closer to the suspicious area. The ability to save the ongoing endoscopic examinations and operations on disk allows you to create a base for assessing the dynamics of the treatment.

Endoscopic surgery of the paranasal sinuses - FESS- Functional Endoscopic Sinus Surgery is by far the most optimal method of surgical treatment of chronic sinusitis. Performing such operations requires not only a good knowledge of the endoscopic anatomy of the intranasal structures, but also the ability to perform endoscopic manipulations bimanually.

Of great importance in the development of diseases of the paranasal sinuses are pathological changes in the region of the middle nasal passage, where their fistulas open. The goal of surgical treatment for chronic maxillary sinusitis is to create an adequate communication between the sinus and the nasal cavity. This restores ventilation and sinus drainage. Through an expanded natural anastomosis, all pathological contents from the sinus can be removed - purulent discharge, foreign body, cyst, mucocele, polyps.

Visual control allows to preserve unchanged structures as much as possible. For the treatment of frontal sinusitis, it is necessary to restore ventilation of the frontal sinus through the natural frontal-nasal canal. For ethmoid and sphenoid sinuses, the same principle is used: if necessary, the maximum number of affected cells of the ethmoid labyrinth is opened, but not all of them. The preservation of not only normal but also pathologically altered mucosa is one of the concepts of endoscopic sinus surgery. It has been shown that the restoration of normal ventilation of the sinuses promotes the regeneration of the mucous membrane.

It is necessary to take into account the fact that the development of chronic sinusitis may be associated with pathological changes in the nasal cavity: curvature of the nasal septum, hypertrophy of the middle or inferior turbinates. In this regard, in order to achieve a good effect in operations on the paranasal sinuses, the nasal septum is corrected, the destruction of the inferior turbinates, and partial resection of the middle turbinate.

To stop nosebleeds in the postoperative period, sponge tampons are used. Such a tamponade is well tolerated by patients, it is easily and painlessly removed from the nasal cavity on the 2nd day after the operation.

Using FESS method allows not only to restore normal nasal breathing, but also to preserve the anatomy of the nasal cavity and paranasal sinuses as much as possible. Such operations are easily tolerated by patients and do not require a long hospital stay. After the intervention, the recovery period takes about a week.

Postoperative care of the nasal cavity is also important - removal of clots and crusts, the appointment of anti-inflammatory, anti-edematous and antibacterial therapy. This prevents adhesions and promotes better healing.