Evolving trends in powered endoscopic sinus surgery.

The modern rhinologist has a wide variety of powered tools at his or her disposal. Innovations in powered instrumentation include the suction-irrigation drill, the coblator, and the introduction of a bone-cutting ultrasonic aspirator. The primary drawback of powered instruments continues to be the higher costs associated with their use, whereas their main advantage is the ability to accomplish multiple functions, such as bone removal, suction, and irrigation, with one tool. The effective use of any powered instrument requires an intimate understanding of its capabilities and limitations. This article provides a brief review of powered instrumentation used in endoscopic sinus and skull base surgery and explores the history, technical details, and potential applications of these exciting tools. Evolution in the design and functioning of the microdebrider are discussed elsewhere.