Uncinectomy is the first surgical step to gain access to the ostiomeatal complex. In the case of isolated disease of the maxillary sinus, resection can be limited to the inferior part of the uncinate process just to expose the natural ostium of the maxillary sinus and the area of the posterior fontanelle (Fig. 5.4a). On the other hand, when the patient presents inflammatory changes only in the frontal sinus, superior uncinec-tomy may enable an adequate exposure of the frontal recess (Fig. 5.4b). Whenever the surgeon is dealing
with extensive disease, the uncinate process must be entirely resected (Fig. 5.4c). CT scan, other than supplying information regarding possible anatomic variations of the uncinate process (i.e., pneumatiza-tion, paradoxical curvature) and the configuration of its upper part in relation to adjacent structures, clearly shows the relationship between the uncinate process and the lamina papyracea. This allows the surgeon to minimize the risk to penetrate the orbit during surgical maneuvers.
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