Anatomical landmarks in revision sinus surgery and advanced nasal polyposis

Endoscopic sinus surgery has been shown to be safe and effective when used appropriately for the management of chronic rhinosinusitis. However, in cases of revision surgery or advanced sinonasal polyposis or both, the usual anatomical landmarks that guide the endoscopic sinus surgeon can be distorted or obstructed from view, making dissection difficult and potentially dangerous if the surgeon does not have a method and understanding of the anatomy to navigate their way safely through the sinonasal cavity. In this article, we describe several consistent landmarks for orienting the surgeon during challenging cases. The use of these landmarks will aid the surgeon in safely navigating through the sinonasal cavity.