["Radical" versus "functional" surgery of the paranasal sinuses-A contradiction?]
„Radikale“ vs. „funktionelle“ Chirurgie der Nasennebenhöhlen – ein Widerspruch?
Chronic rhinosinusitis with nasal polyps CRSwNP
Draf III
FESS
Radical paranasal sinus surgery
Surgical concept
Journal
HNO
ISSN: 1433-0458
Titre abrégé: HNO
Pays: Germany
ID NLM: 2985099R
Informations de publication
Date de publication:
25 Oct 2023
25 Oct 2023
Historique:
accepted:
05
09
2023
medline:
26
10
2023
pubmed:
26
10
2023
entrez:
25
10
2023
Statut:
aheadofprint
Résumé
The terms "functional" and "radical" paranasal sinus surgery were often considered to be different operations which were mutually exclusive. This overview aims to look at the basics of these terms and surgical procedures and to work out the resulting surgical concepts for clinically relevant indications. Selective literature analysis using the data base PubMed, corresponding textbooks and resulting secondary literature regarding functional and radical or extended paranasal sinus surgery. Similarly, the current literature regarding clinically relevant indications for sinus surgery were analyzed. Modern pathophysiological knowledge, anatomically and pathophysiologically substantiated endoscopic surgical procedures and the usage of up to date technical possibilities have resulted in concepts which combine functional and so-called radical or extended surgery of the paranasal sinuses that complement each other and sometimes even overlap. The preoperative diagnosis and definition of underlying diseases are decisive and should be as precise as possible, as the extent and surgical details mainly depend on them: a sole creation of free drainage pathways, an additional creation of anatomical access for subsequent topical treatment or a complete (radical) removal of a pathological process. HINTERGRUND UND ZIEL DER ARBEIT: Die Begriffe „funktionelle“ und „radikale“ Nasennebenhöhlenchirurgie gelten häufig als Beschreibung von Operationen, die sich ausschließen und eher unvereinbar gegenüberstehen. In dieser Übersichtsarbeit sollen die Grundlagen der hinter den Begriffen stehenden Eingriffe und die sich hieraus ergebenden aktuellen Therapiekonzepte herausgearbeitet werden. Selektive Literaturrecherche in der Literaturdatenbank Pubmed, Themen bezogenen Textbüchern bzw. in hieraus sich ergebender Sekundärliteratur zur funktionellen und radikalen Nasennebenhöhlenchirurgie. Gleichartig wurde die aktuelle Literatur zu den klinisch relevanten Indikationen zur Nasennebenhöhlenchirurgie durchgesehen und bewertet. Moderne pathophysiologische Erkenntnisse, eine anatomisch und pathophysiologisch begründete endoskopische Vorgehensweise und die Nutzung aktueller technischer Möglichkeiten haben dazu geführt, dass funktionelle und sogenannte radikale bzw. erweiterte Nasennebenhöhlenchirurgie sich ergänzen und teilweise sogar überlappen. Dies macht die präoperative Diagnostik und Definition der zugrundeliegenden Erkrankung umso wichtiger, da sich hieraus das operative Konzept ergibt, in welchem Ausmaß und in welchem Detail operiert werden soll: ausschließliche Schaffung einer freien Drainage, ergänzende Schaffung eines Zuganges zur Anwendung topischer Therapien oder die vollständige (radikale) Entfernung eines krankhaften Prozesses.
Sections du résumé
BACKGROUND AND OBJECTIVE
OBJECTIVE
The terms "functional" and "radical" paranasal sinus surgery were often considered to be different operations which were mutually exclusive. This overview aims to look at the basics of these terms and surgical procedures and to work out the resulting surgical concepts for clinically relevant indications.
MATERIAL AND METHODS
METHODS
Selective literature analysis using the data base PubMed, corresponding textbooks and resulting secondary literature regarding functional and radical or extended paranasal sinus surgery. Similarly, the current literature regarding clinically relevant indications for sinus surgery were analyzed.
RESULTS AND CONCLUSION
CONCLUSIONS
Modern pathophysiological knowledge, anatomically and pathophysiologically substantiated endoscopic surgical procedures and the usage of up to date technical possibilities have resulted in concepts which combine functional and so-called radical or extended surgery of the paranasal sinuses that complement each other and sometimes even overlap. The preoperative diagnosis and definition of underlying diseases are decisive and should be as precise as possible, as the extent and surgical details mainly depend on them: a sole creation of free drainage pathways, an additional creation of anatomical access for subsequent topical treatment or a complete (radical) removal of a pathological process.
ZUSAMMENFASSUNG
UNASSIGNED
HINTERGRUND UND ZIEL DER ARBEIT: Die Begriffe „funktionelle“ und „radikale“ Nasennebenhöhlenchirurgie gelten häufig als Beschreibung von Operationen, die sich ausschließen und eher unvereinbar gegenüberstehen. In dieser Übersichtsarbeit sollen die Grundlagen der hinter den Begriffen stehenden Eingriffe und die sich hieraus ergebenden aktuellen Therapiekonzepte herausgearbeitet werden.
MATERIAL UND METHODEN
METHODS
Selektive Literaturrecherche in der Literaturdatenbank Pubmed, Themen bezogenen Textbüchern bzw. in hieraus sich ergebender Sekundärliteratur zur funktionellen und radikalen Nasennebenhöhlenchirurgie. Gleichartig wurde die aktuelle Literatur zu den klinisch relevanten Indikationen zur Nasennebenhöhlenchirurgie durchgesehen und bewertet.
ERGEBNISSE UND DISKUSSION
UNASSIGNED
Moderne pathophysiologische Erkenntnisse, eine anatomisch und pathophysiologisch begründete endoskopische Vorgehensweise und die Nutzung aktueller technischer Möglichkeiten haben dazu geführt, dass funktionelle und sogenannte radikale bzw. erweiterte Nasennebenhöhlenchirurgie sich ergänzen und teilweise sogar überlappen. Dies macht die präoperative Diagnostik und Definition der zugrundeliegenden Erkrankung umso wichtiger, da sich hieraus das operative Konzept ergibt, in welchem Ausmaß und in welchem Detail operiert werden soll: ausschließliche Schaffung einer freien Drainage, ergänzende Schaffung eines Zuganges zur Anwendung topischer Therapien oder die vollständige (radikale) Entfernung eines krankhaften Prozesses.
Autres résumés
Type: Publisher
(ger)
HINTERGRUND UND ZIEL DER ARBEIT: Die Begriffe „funktionelle“ und „radikale“ Nasennebenhöhlenchirurgie gelten häufig als Beschreibung von Operationen, die sich ausschließen und eher unvereinbar gegenüberstehen. In dieser Übersichtsarbeit sollen die Grundlagen der hinter den Begriffen stehenden Eingriffe und die sich hieraus ergebenden aktuellen Therapiekonzepte herausgearbeitet werden.
Identifiants
pubmed: 37880356
doi: 10.1007/s00106-023-01378-8
pii: 10.1007/s00106-023-01378-8
doi:
Types de publication
English Abstract
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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