ABSTRACT
The structures of the posterior nasal choana (i.e., the eustachian tube opening, choanal arch, posterior septum, and posterior nasopharyngeal wall), along with the inferior turbinate, are routinely identified with a O-degree or 30-degree telescope before proceeding with endoscopic surgery of the paranasal sinuses. Identification of these structures early on establishes the anteroposterior dimensions of the nasal airway, provides a drainage route for blood into the nasopharynx, and facilitates the introduction of endoscopic surgical instrumentation and telescopes. Hypertrophied middle and/or inferior turbinates, and/or a septal spur or deviation obstructing the nasal airway or limiting endoscopic exposure, are addressed prior to proceeding with any sinus work. When bilateral polyp disease is present, a bilateral nasal polypectomy is performed first to re-establish the anteroposterior dimensions of the nose, as well as to facilitate the placement of a contralateral nasopharyngeal suction.
