Copyright @ 200 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited. 8 The Results of Concurrent Functional Endoscopic Sinus Surgery and Rhinoplasty Selcuk Inanli, MD, Murat Sari, MD, Mine Zahide Yazici, MD Marmara, Turkey Objective: The indications, management, and results are discussed in 45 patients who underwent the concurrent functional endoscopic sinus surgery (FESS) and rhinoplasty. Study Design: Retrospective clinical study. Patients and Methods: There were 27 women and 18 men with a mean age of 28 years. 28 patients had chronic rhinosinusitis and 17 patients had nasal polyposis refractory to medical therapy underwent the combined procedure by the same otolaryngologist. Results: A review of our 45 combined procedure performed between 2000 and 2005. There were no lifethreatening severe complications noted in this population. The patients were also satisfied with the aesthetic outcome. Conclusion: Combined rhinoplasty and endoscopic sinus surgery can be performed safely, cost- effec- tively and with perfect results in selected patients. Key Words: Functional endoscopic sinus surgery, rhinoplasty, combination O ver the last decade, functional endoscopic sinus surgery (FESS) has become the surgical modality of choice in the treat- ment of inflammatory sinus disease refractory to medical therapy. During the same interval, interest in cosmetic surgery procedures in- cluding rhinoplasty has exploded. 1 Many surgeons are performing rhinoplasty combined with endo- scopic sinus surgery as a means to decrease operat- ing times, healing times, as well as patient cost. 2 The potential risk for infection and complications of the sinus procedure have avoided concurrent surgery. The increased use of antibiotics for chronic sinusitis at long time period has reduced infection risk. Endoscopic techniques, combined with modern imaging techniques using computerized tomography (CT), have revolutionized therapy for all paranasal sinus surgery for inflammatory disease. These advances have made simultaneous procedure safe and efficacious in appropriately selected patients with sinus diseases. There are few publications about effeciveness and complications of this combined procedure in the literature. Here in we report our cases who undergone concurrent functional endo- scopic sinus surgery (FESS) and rhinoplasty. PATIENTS AND METHODS F orty five patients were treated by this combined procedure and 43 (95,5%) were available for follow up. Follow-up ranged from 6 months to 6 years, with a mean follow-up of 29 months. There were 27 women and 18 men ranging in age from 19 to 35 years (mean age, 27.2 years). 28 patients had chronic rhinosinusitis and 17 patients had nasal polyposis refractory to medical therapy underwent the combined procedure by the same otolaryngolo- gist. All of the patients had undergone a primary procedure. Careful review of the patient’s medical history was the first step for all surgical procedure; the second was questioning the patient’s complaints. Photos were taken at the preoperative period (Fig 1AYD). After aesthetic concerns of the patient; the otorhinolaryngological work up consisted of a thorough history, complete head and neck examina- tion, office rigid nasal endoscopy, as well as fine-cut (4 mm) CT scanning of the paranasal sinuses (axial and coronal views). Prior to proceeding with the surgery, all patients had clearly defined anatomic abnormalities identified on CT scans (Fig 2A, B). CT findings revealed the extent of functional and inflammatory abnormality: lower/middle turbinate hypertrophy or pneumatization, septal deviation, obstruction of ostiomeatal complex, polyposis, or ethmoidal/maxillary/sphenoidal/frontal sinusitis. All procedures were performed by the same surgeon under general anesthesia with endoscopic nasal sinus surgery performed first, followed by 701 From the Department of Otorhinolaryngology, Head and Neck Surgery, Marmara University School of Medicine, Istanbul, Turkey. Address correspondence and reprint requests to Dr. Mine Zahide Yazici, Marmara University Medical Faculty, Haydarpasa, 34668, Istanbul, Turkey; E-mail: minealmaz@yahoo.com