The minimally invasive sinus technique: Concepts and controversies

The minimally invasive sinus technique, or MIST, is different from minimally invasive sinus surgery. Some claim the latter as the definition of functional endoscopic sinus surgery, or FESS. However, MIST implies a treatment philosophy and surgical model that is quite different from FESS. The goals of this article are to discuss the origins of functional sinus surgery as it relates to the evolution of FESS and MIST, define MIST as a philosophy and surgical model, discuss treatment of surgical sinus disease, and challenge the rationale for our departure from Messerklinger’s “functional” concepts into what will be referred to as “contemporary FESS.” Finally, outcome studies validating the MIST as a primary surgical model for treating patients with refractory sinus symptoms will be presented and discussed.