operative techinqueAfter the administration of general anesthesia and intubation, cotton pads saturated with 0.05% oxymetazoline were applied to the anterior area of the nose.
Drainage of the SPOA was performed under endoscopic visualization using 2.7-mm and 4-mm 0 degrees and 30 degrees telescopes.
The middle turbinate is gently retracted medially to provide exposure of the bulla ethmoidalis alone. Partial uncinectomy was performed to provide exposure of the anterior and medial walls of the bulla ethmoidalis, but this is later discontinued as access to the medial wall of the bulla ethmoidalis proved sufficient. After completing an ethmoidectomy using the anterior-to-posterior or combined approach, careful homeostasis is obtained using packing saturated with a vasoconstrictive agent and bipolar cautery as needed
Because infection spreads from the ethmoid sinus, the lamina papyracea is often partially dehiscent in patients with a subperiosteal abscess. Using a bone curette, sufficient lamina papyracea should be removed to provide wide drainage of the abscess into the ethmoid cavity.
The periosteum can be incised in those rare instances where the abscess is within the adjacent orbit and drained into the ethmoid sinus. However, exposure and drainage of this site is difficult. After aspirating and sending the infectious material for gram staining and appropriate microbiologic studies, the abscess cavity should be irrigated vigorously with saline, and the procedure is completed without the placement of intrasinus packing and intranasal and intrasinus ointment.
posoperative finding
