Although most chronic ethmoid sinus infections are amenable to endoscopic sinus surgery or intranasal ethmoidectomy, external ethmoidectomy is still useful in certain situations. It is an operation designed to gain access to the ethmoid sinuses via an external incision placed between the corner of the eye and the nose. This operation is indicated for cleaning irreversible mucosal disease in the sinus, recurrent sinus disease, polyposis, chronic obstruction to the drainage of infection from the sinuses and sometimes, as an approach to the sphenoid and pituitary gland. Occasionally, this operation is also performed to remove a mucocele or a tumor of the ethmoids. Complications include postoperative bleeding, orbital complications (eyelid swelling, visual impairment or double vision), intracranial extension (brain damage or infection), leakage of cerebrospinal fluid, excessive tearing, scar formation, persistent or recurrent nasal obstruction due to failure to manage polyps and recurrent nasal or sinus infections.
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