ABSTRACT
The uncinate process is a very important landmark in functional endoscopic sinus surgery, as its removal is the first step in anterior ethmoidectomy. An understanding of the anatomic variations of the uncinate process in any patient undergoing functional endoscopic sinus surgery [FESS] is critical to safely performing the infundibulotomy. The traditional method of performing infundibulotomy has the risk of penetration of the lamina papyracea with orbital fat exposure. Our aim of this Study was :1- To study the anatomical variations of the uncinate process in cadavers and CT scans of Egyptian population.2-To compare the traditional surgical technique of infundibulotomy and another technique of infundibulotomy [Retrograde infundibulotomy] .The incidence of orbital penetration, the ease of identification of the natural maxillary ostium and lacrimal apparatus injury by each technique were reported. The work was carried out on 30 cadaveric specimens, 100 radiological films and 100 patients of FESS. We the anatomical variations of the uncinate process in cadavers and C.T scans of Egyptian population were documented. The incidence of orbital penetration and - ostium non-identification was significantly less with the retrograde technique. No naso-lacrimal duct injury occurred with either technique of infundibulotomies. The techniques were described and the complications discussed .The retrograde technique of infundibulotomy is recommended technique as it is easy to learn, allows easy identification of the natural ostium of the maxillary sinus and is associated with significantly decreased incidence of orbital penetration