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>> Dr. Lamperti: This is Dr. Thomas Lamperti. Today I'm going to about how to open up the
cheek sinus during a sinus surgery. The technical name for this procedure is a maxillary antrostomy.
This terminology comes from the fact that we're opening up the maxillary sinus and the
antrum is the window or opening of the sinus. Our first step is to perform an uncinectomy.
This is what we're doing right now as we incise the mucosa or skin lining over the uncinate
process. The uncinate process is the shelf of tissue that lays right in front of the
natural maxillary atrium or opening. You can see just a part of it there as we make an
incision in the uncinate. And as the name implies an uncinectomy involves removing this
tissue. So were using a device to remove this portion of thin bone and skin lining. And
now we're using a shaver or micro-debridder to shave some of that excess tissue and fine
tune the edges. When people conceive of sinus surgery they often think of a roto-rooter
procedure and this device is probably the most analogous to that. This view shows you
the device and the shaver blade. There is also irrigation that goes through as it suctions
also. And this allows us to remove the tissue that we need to remove, including polyps in
certain cases, while sparing any mucosa or skin lining that we don't want to injure.
This device is called a back-biter. You can see why we call it that. This is allowing
me to remove some additional tissue and open up the cheek sinus further. And now we're
placing some dissolvable packing. In most cases in my practice this is the extent of
the packing that I'll place during sinus surgery -- and it is dissolvable. As you can see there
is still quite a bit of room still in the nose and you're still able to breathe through
your nose if you like. And this packing will dissolve over time and you do salt water rinses
and flushes. This packing has two roles. The first is to stop the oozing from the cut edges
and also to help prevent adhesions or scar bands.
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