Weber Rainer K, Hildenbrand Tanja, Kühnel Thomas, Hoffmann Thomas K, Betz Christian, Sommer Fabian
Sektion Nasennebenhöhlen- und Schädelbasischirurgie, Traumatologie, Klinik für Hals‑, Nasen- und Ohrenheilkunde, Städtisches Klinikum Karlsruhe, Moltkestraße 90, 76133, Karlsruhe, Deutschland.
Sinus Academy, Karlsruhe, Deutschland.
HNO. 2024 Feb;72(2):102-112. doi: 10.1007/s00106-023-01378-8. Epub 2023 Oct 25.
The terms "functional" and "radical" paranasal sinus surgery were often considered to be different operations which were mutually exclusive. This overview aims to look at the basics of these terms and surgical procedures and to work out the resulting surgical concepts for clinically relevant indications.
Selective literature analysis using the data base PubMed, corresponding textbooks and resulting secondary literature regarding functional and radical or extended paranasal sinus surgery. Similarly, the current literature regarding clinically relevant indications for sinus surgery were analyzed.
Modern pathophysiological knowledge, anatomically and pathophysiologically substantiated endoscopic surgical procedures and the usage of up to date technical possibilities have resulted in concepts which combine functional and so-called radical or extended surgery of the paranasal sinuses that complement each other and sometimes even overlap. The preoperative diagnosis and definition of underlying diseases are decisive and should be as precise as possible, as the extent and surgical details mainly depend on them: a sole creation of free drainage pathways, an additional creation of anatomical access for subsequent topical treatment or a complete (radical) removal of a pathological process.
“功能性”和“根治性”鼻旁窦手术这两个术语常被视为不同且相互排斥的手术方式。本综述旨在探讨这些术语及手术操作的基础，并梳理出针对临床相关适应症的手术概念。
利用PubMed数据库、相关教科书及由此产生的关于功能性和根治性或扩大性鼻旁窦手术的二次文献进行选择性文献分析。同样，对当前关于鼻窦手术临床相关适应症的文献进行分析。
现代病理生理学知识、基于解剖学和病理生理学的内镜手术操作以及对最新技术可能性的运用，已形成了将功能性手术与所谓的根治性或扩大性鼻旁窦手术相结合的概念，这些概念相互补充，有时甚至重叠。基础疾病的术前诊断和定义至关重要，应尽可能精确，因为手术范围和细节主要取决于它们：单纯建立自由引流通道、为后续局部治疗额外建立解剖入路或彻底（根治性）切除病变过程。
