[Surgical revision of the lateral nasal wall]

The purpose of rhinosinus revision through endoscopic surgery is to resolve
recurrent, residual pathologies in patients with drug-resistant symptoms and to
prevent ocular and endocranial complications. Surgical revision proves quite
complex because of the destruction of the anatomical structures. More over the
presence of tougher scare tissue which bleeds easily increases the risk of
iatrogenous complications. Axial and coronal-projection tomography without
contrast medium must be performed prior to surgery. Endonasal orientation is
ensured by six main reference points. Three of these points--nasal septum, upper
edge of the choana and upper edge of the nasolacrymal duct--are nearly always
present while the others may or may not be, depending on what sort surgery has
been performed. The present work gives the guidelines for a correct approach to
patients who have undergone many previous procedures.