Review of Swing-door and Classical Method of Uncinectomy in Endoscopic Sinus Surgery

Abstract

Introduction:
This study aims to review the classical and swing door methods of uncinectomy during
endoscopic sinus surgery and compare the most standard techniques regarding their
efficiency and safety.
Materials and Methods:
One hundred Cases of sinusitis were selected and operated for Functional EndoscopicSinus
Surgery (FESS). Out of these, in 50uncinectomies classical uncinectomy was donewhereas in
another 50uncinectomies swing door technique was used. Initially patients weremedically
managed and treated according to their symptoms and prior management. Patients whohad
received previous adequate medical management were evaluated with CT scan of
theparanasal air sinuses. If disease still persists than they were operated for FESS.The most
familiar two methods of doing uncinectomy are the classic method, introduced by
Stammberger in 1986, and Wormald‘s swing-door technique in 1998.
Results: In this review classical method was used in 50uncinectomies. Out of this, ethmoidal
complex injury was noted in 30 cases,missed maxillary ostium syndrome (incomplete
removal) was reported in 3 patients andorbital fat exposure was encountered in 1 patient. As
compared to 50uncinectomies donewith swing door technique, incomplete removal was
evident in 1 case and lacrimal duct injury was reported in 1 case.The swing-door technique
appears to be associated with a slightly higher risk of injury to the lacrimal duct.
Simultaneously, incidence of orbital penetration, incomplete removal, ethmoidal complex
injury and ostium non-identification was more common in the classic method.
Conclusion:The swing door technique for uncinectomy produces good postoperative results,
with fewer complications, as compared to the standard technique.