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The ‘swing-door’ technique for uncinectomy in endoscopic sinus surgery

Published online by Cambridge University Press:  29 June 2007

P. J. Wormald*
Affiliation:
Department of Otolaryngology, Chinese University of Hong Kong, Pretoria, South Africa.
Mike McDonogh
Affiliation:
Department of Otolaryngology, Hong Kong and Waterkloof, Pretoria, South Africa.
*
Address for correspondence: P. J. Wormald, Division of Surgery, Queen Elizabeth Hospital, 28 Woodville Road, Woodville South 5011, South Australia.

Abstract

Uncinectomy is an important step in endoscopic sinus surgery. The traditional method of performing uncinectomy has the risk of penetration of the lamina papyracea with orbital fat exposure. If the orbital penetration is not recognized, major complications may follow. In this study the authors used historical consecutive controls to compare the incidence of orbital penetration, identification of the natural ostium and lacrimal apparatus injury by the traditional surgical technique and a new technique of uncinectomy. Six hundred and thirty-six uncinectomies have been performed using the ‘swing-door’ technique. The 636 uncinectomies performed prior to changing techniques were used as historical controls. The incidence of orbital penetration (six compared to 0; p<0.05) and ostium non-identification (42 not identified as compared to 0; p<0.001) was significantly less with the new technique. One lacrimal injury occurred with the ‘swing-door’ technique compared to zero with the standard technique (p>0.05). The techniques are described and the complications discussed. The authors recommend this technique as it is easy to learn, allows removal of the uncinate flush with the lateral nasal wall and allows easy identification of the natural ostium of the maxillary sinus.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1998

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