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The small-hole technique in endoscopic sinus surgery.

It may be that the uncinate process, the posteromedial wall of the agger nasi, and the medial wall of the ethmoid bulla are the critical anatomic components in recalcitrant sinus disease. The basal lamella may be a fourth component. It may be that addressing these "transition spaces" is all that is required in cases of sinusitis requiring surgical treatment. Quantitative studies and outcome studies are necessary. Minimally invasive, "small hole" sinus surgery may offer the prospect of reversibility of disease in the paranasal sinuses with limited surgical intervention.