[Transnasal, endoscopical sinus surgery for chronic sinusitis. I. A biomechanical concept of the endonasal mucosa surgery (author's transl)].

Transnasal, endoscopical operations are recommended for the surgical treatment of chronic sinusitis. They are based on a bio-mechanical concept of recovery of the diseased mucosa, initiated by the restoration of ventilation and drainage to the paranasal cavities. These interventions, e.g. endonasal maxillary sinus operation and endonasal total ethmoidectomy, intend to remove narrow straits within the pneumatic system ("isthmus surgery"), but to preserve the lining mucosa. Flanking measures are necessary, in order to rule out etiologic cofactors of the sinusitis (septoplasty, conchotomy, tonsillectomy). Special instrumentation and the development of the surgical suction-irrigation-endoscope were prerequisite for this type of rhino-surgery, which also requires intimate knowledge of the topographical anatomy.