Extended Applications of Endoscopic Sinus Surgery to the Orbit and Pituitary Fossa

There has been significant evolution over time from external headlight sinus surgery to endoscopic sinus surgery(ESS). ESS was pioneered by Messenklinger, who discovered that the sinuses had a predetermined mucociliary clearance pattern towards the natural ostium irrespective of additional openings into the sinuses. This philosophy of opening the natural ostium of the diseased sinus was then popularized by Stammberger and Kennedy. ESS is now accepted as the surgical management of choice for chronic sinusitis. Furthermore, as our knowledge of the anatomy of the sinuses has improved, other anciliary surgeries such as endoscopic lacrimal surgery, orbital decompression, applications to the pterygopalatine and infratemporal fossa, approaches from the sphenoid/sella extending to the cribriform, parasellar and clival region have evolved. Moreover, innovation in instrumentation has led to the acceptance of endoscopic management of benign endonasal tumors and more recently, on endoscopic management of malignant tumors of the nose and sinuses.