Ethmoidectomy Surgical Coaching

Kaiser Permanente Surgical Coaching Ethmoidectomy: Step 1) Local anesthetic injection - Use 0-degree endoscope and 25 gauge spinal needle to inject 1-2 mL of 1% lidocaine with 1:100,000 epinephrine at sphenopalatine artery (1cm above the inferior border of the inferior attachment of the middle turbinate to the lateral nasal wall). Best practice -- 2 bend technique of spinal needle Step 2) Medialize middle turbinate and identify the medial border of the ethmoid bulla - Use freer elevator or back end of J