Question:medium
During functional endoscopic sinus surgery (FESS), the patient is usually placed in which position?
During functional endoscopic sinus surgery (FESS), the patient is usually placed in which position?
Show Hint
You want the head above heart level to keep the sinus field dry.
Updated On: Jun 24, 2026
- Trendelenburg
- Lateral
- Reverse Trendelenburg
- Lithotomy
Show Solution
The Correct Option is C
Solution and Explanation
Step 1: The single biggest threat to a clear endoscopic view during sinus surgery is oozing of blood, so the surgeon and anaesthetist work together to minimise it, partly through patient posture.
Step 2: Tilting the table head-up, the reverse Trendelenburg posture, drops the hydrostatic pressure in the head and neck vessels, reducing both arterial inflow pressure and venous pooling at the sinuses.
Step 3: Less bleeding means a cleaner field, fewer complications and shorter operating time, which is why this head-elevated position is the routine choice for FESS.
Step 4: A head-down tilt would worsen congestion, and lateral or lithotomy positions belong to other specialties, so the correct posture is reverse Trendelenburg.
\[\boxed{\text{Reverse Trendelenburg}}\]
Step 2: Tilting the table head-up, the reverse Trendelenburg posture, drops the hydrostatic pressure in the head and neck vessels, reducing both arterial inflow pressure and venous pooling at the sinuses.
Step 3: Less bleeding means a cleaner field, fewer complications and shorter operating time, which is why this head-elevated position is the routine choice for FESS.
Step 4: A head-down tilt would worsen congestion, and lateral or lithotomy positions belong to other specialties, so the correct posture is reverse Trendelenburg.
\[\boxed{\text{Reverse Trendelenburg}}\]
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