Microendoscopic Surgery: Knowledge of the Basic Principles

Microscopic and endoscopic surgery of the nose and paranasal sinuses were separately developed in Europe at the end of the 1950s and in the early 1970s thanks to Heermann (1958) and MesserklingeR (1972, 1978), respectively. Among others, Draf (1991; Draf and Weber 1993) for microscopic surgery, and Stammberger (1986a,b) and Wigand (1981) for en-doscopic surgery have contributed tremendously to spreading the use of these techniques all around the world. The microscope has the advantage of a binocular view, which gives a tridimensional perspective and a better sense of depth; furthermore, the surgeon can use both hands for surgical maneuvers, a peculiarity which can be extremely helpful in situations of massive bleeding. Endoscopes are available with lenses of different angulation (Fig. 5.1); this enables a good view of the most remote recesses of the sinonasal compartment (i.e., frontal recess and sinus, maxillary sinus), something which is not feasible with a microscope. Furthermore, endoscopes, which are presently used coupled with a camera connected with a highresolution video, are excellent for photodocumentation. After a period of disputes opposing supporters


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