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  5. 09B - Excision

ICD-10-PCS 09B Medical and Surgical: Ear, Nose, Sinus Excision

The ICD-10-PCS root operation Excision (code character 09B) refers to the cutting out or off of a portion of a body part. In the Medical and Surgical section focusing on the Ear, Nose, and Sinus body systems, this operation involves removing tissue or a segment of anatomical structures for therapeutic or diagnostic purposes.

This classification includes excision procedures performed on various parts such as the External Ear, External Auditory Canal, Middle Ear, Tympanic Membrane, Auditory Ossicle, Mastoid Sinus, Inner Ear, Eustachian Tube, and multiple nasal and sinus structures like the Nasal Septum and Maxillary Sinus. Excisions can be approached in different ways including Open, Percutaneous, Percutaneous Endoscopic, External, or via Natural or Artificial Openings. For example, code 09B00ZZ describes excision of the Right External Ear via an Open Approach, while 09BQ4ZZ indicates excision of the Right Maxillary Sinus using a Percutaneous Endoscopic Approach. These precise codes support detailed documentation of excision procedures in the ear, nose, and sinus region.

List of ICD-10-PCS codes used to specify 09B - Excision (cutting out or off, without replacement, a portion of a body part). There are a total of 231 procedure codes in this section.

  • 09B - Ear, Nose, Sinus, Excision

  • 09B00ZX - Excision of Right External Ear, Open Approach, Diagnostic

  • 09B00ZZ - Excision of Right External Ear, Open Approach

  • 09B03ZX - Excision of Right External Ear, Percutaneous Approach, Diagnostic

  • 09B03ZZ - Excision of Right External Ear, Percutaneous Approach

  • 09B04ZX - Excision of Right External Ear, Percutaneous Endoscopic Approach, Diagnostic

  • 09B04ZZ - Excision of Right External Ear, Percutaneous Endoscopic Approach

  • 09B0XZX - Excision of Right External Ear, External Approach, Diagnostic

  • 09B0XZZ - Excision of Right External Ear, External Approach

  • 09B10ZX - Excision of Left External Ear, Open Approach, Diagnostic

  • 09B10ZZ - Excision of Left External Ear, Open Approach

  • 09B13ZX - Excision of Left External Ear, Percutaneous Approach, Diagnostic

  • 09B13ZZ - Excision of Left External Ear, Percutaneous Approach

  • 09B14ZX - Excision of Left External Ear, Percutaneous Endoscopic Approach, Diagnostic

  • 09B14ZZ - Excision of Left External Ear, Percutaneous Endoscopic Approach

  • 09B1XZX - Excision of Left External Ear, External Approach, Diagnostic

  • 09B1XZZ - Excision of Left External Ear, External Approach

  • 09B30ZX - Excision of Right External Auditory Canal, Open Approach, Diagnostic

  • 09B30ZZ - Excision of Right External Auditory Canal, Open Approach

  • 09B33ZX - Excision of Right External Auditory Canal, Percutaneous Approach, Diagnostic

  • 09B33ZZ - Excision of Right External Auditory Canal, Percutaneous Approach

  • 09B34ZX - Excision of Right External Auditory Canal, Percutaneous Endoscopic Approach, Diagnostic

  • 09B34ZZ - Excision of Right External Auditory Canal, Percutaneous Endoscopic Approach

  • 09B37ZX - Excision of Right External Auditory Canal, Via Natural or Artificial Opening, Diagnostic

  • 09B37ZZ - Excision of Right External Auditory Canal, Via Natural or Artificial Opening

  • 09B38ZX - Excision of Right External Auditory Canal, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09B38ZZ - Excision of Right External Auditory Canal, Via Natural or Artificial Opening Endoscopic

  • 09B3XZX - Excision of Right External Auditory Canal, External Approach, Diagnostic

  • 09B3XZZ - Excision of Right External Auditory Canal, External Approach

  • 09B40ZX - Excision of Left External Auditory Canal, Open Approach, Diagnostic

  • 09B40ZZ - Excision of Left External Auditory Canal, Open Approach

  • 09B43ZX - Excision of Left External Auditory Canal, Percutaneous Approach, Diagnostic

  • 09B43ZZ - Excision of Left External Auditory Canal, Percutaneous Approach

  • 09B44ZX - Excision of Left External Auditory Canal, Percutaneous Endoscopic Approach, Diagnostic

  • 09B44ZZ - Excision of Left External Auditory Canal, Percutaneous Endoscopic Approach

  • 09B47ZX - Excision of Left External Auditory Canal, Via Natural or Artificial Opening, Diagnostic

  • 09B47ZZ - Excision of Left External Auditory Canal, Via Natural or Artificial Opening

  • 09B48ZX - Excision of Left External Auditory Canal, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09B48ZZ - Excision of Left External Auditory Canal, Via Natural or Artificial Opening Endoscopic

  • 09B4XZX - Excision of Left External Auditory Canal, External Approach, Diagnostic

  • 09B4XZZ - Excision of Left External Auditory Canal, External Approach

  • 09B50ZX - Excision of Right Middle Ear, Open Approach, Diagnostic

  • 09B50ZZ - Excision of Right Middle Ear, Open Approach

  • 09B58ZX - Excision of Right Middle Ear, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09B58ZZ - Excision of Right Middle Ear, Via Natural or Artificial Opening Endoscopic

  • 09B60ZX - Excision of Left Middle Ear, Open Approach, Diagnostic

  • 09B60ZZ - Excision of Left Middle Ear, Open Approach

  • 09B68ZX - Excision of Left Middle Ear, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09B68ZZ - Excision of Left Middle Ear, Via Natural or Artificial Opening Endoscopic

  • 09B70ZX - Excision of Right Tympanic Membrane, Open Approach, Diagnostic

  • 09B70ZZ - Excision of Right Tympanic Membrane, Open Approach

  • 09B73ZX - Excision of Right Tympanic Membrane, Percutaneous Approach, Diagnostic

  • 09B73ZZ - Excision of Right Tympanic Membrane, Percutaneous Approach

  • 09B74ZX - Excision of Right Tympanic Membrane, Percutaneous Endoscopic Approach, Diagnostic

  • 09B74ZZ - Excision of Right Tympanic Membrane, Percutaneous Endoscopic Approach

  • 09B77ZX - Excision of Right Tympanic Membrane, Via Natural or Artificial Opening, Diagnostic

  • 09B77ZZ - Excision of Right Tympanic Membrane, Via Natural or Artificial Opening

  • 09B78ZX - Excision of Right Tympanic Membrane, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09B78ZZ - Excision of Right Tympanic Membrane, Via Natural or Artificial Opening Endoscopic

  • 09B80ZX - Excision of Left Tympanic Membrane, Open Approach, Diagnostic

  • 09B80ZZ - Excision of Left Tympanic Membrane, Open Approach

  • 09B83ZX - Excision of Left Tympanic Membrane, Percutaneous Approach, Diagnostic

  • 09B83ZZ - Excision of Left Tympanic Membrane, Percutaneous Approach

  • 09B84ZX - Excision of Left Tympanic Membrane, Percutaneous Endoscopic Approach, Diagnostic

  • 09B84ZZ - Excision of Left Tympanic Membrane, Percutaneous Endoscopic Approach

  • 09B87ZX - Excision of Left Tympanic Membrane, Via Natural or Artificial Opening, Diagnostic

  • 09B87ZZ - Excision of Left Tympanic Membrane, Via Natural or Artificial Opening

  • 09B88ZX - Excision of Left Tympanic Membrane, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09B88ZZ - Excision of Left Tympanic Membrane, Via Natural or Artificial Opening Endoscopic

  • 09B90ZX - Excision of Right Auditory Ossicle, Open Approach, Diagnostic

  • 09B90ZZ - Excision of Right Auditory Ossicle, Open Approach

  • 09B98ZX - Excision of Right Auditory Ossicle, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09B98ZZ - Excision of Right Auditory Ossicle, Via Natural or Artificial Opening Endoscopic

  • 09BA0ZX - Excision of Left Auditory Ossicle, Open Approach, Diagnostic

  • 09BA0ZZ - Excision of Left Auditory Ossicle, Open Approach

  • 09BA8ZX - Excision of Left Auditory Ossicle, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BA8ZZ - Excision of Left Auditory Ossicle, Via Natural or Artificial Opening Endoscopic

  • 09BB0ZX - Excision of Right Mastoid Sinus, Open Approach, Diagnostic

  • 09BB0ZZ - Excision of Right Mastoid Sinus, Open Approach

  • 09BB3ZX - Excision of Right Mastoid Sinus, Percutaneous Approach, Diagnostic

  • 09BB3ZZ - Excision of Right Mastoid Sinus, Percutaneous Approach

  • 09BB4ZX - Excision of Right Mastoid Sinus, Percutaneous Endoscopic Approach, Diagnostic

  • 09BB4ZZ - Excision of Right Mastoid Sinus, Percutaneous Endoscopic Approach

  • 09BB8ZX - Excision of Right Mastoid Sinus, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BB8ZZ - Excision of Right Mastoid Sinus, Via Natural or Artificial Opening Endoscopic

  • 09BC0ZX - Excision of Left Mastoid Sinus, Open Approach, Diagnostic

  • 09BC0ZZ - Excision of Left Mastoid Sinus, Open Approach

  • 09BC3ZX - Excision of Left Mastoid Sinus, Percutaneous Approach, Diagnostic

  • 09BC3ZZ - Excision of Left Mastoid Sinus, Percutaneous Approach

  • 09BC4ZX - Excision of Left Mastoid Sinus, Percutaneous Endoscopic Approach, Diagnostic

  • 09BC4ZZ - Excision of Left Mastoid Sinus, Percutaneous Endoscopic Approach

  • 09BC8ZX - Excision of Left Mastoid Sinus, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BC8ZZ - Excision of Left Mastoid Sinus, Via Natural or Artificial Opening Endoscopic

  • 09BD0ZX - Excision of Right Inner Ear, Open Approach, Diagnostic

  • 09BD0ZZ - Excision of Right Inner Ear, Open Approach

  • 09BD8ZX - Excision of Right Inner Ear, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BD8ZZ - Excision of Right Inner Ear, Via Natural or Artificial Opening Endoscopic

  • 09BE0ZX - Excision of Left Inner Ear, Open Approach, Diagnostic

  • 09BE0ZZ - Excision of Left Inner Ear, Open Approach

  • 09BE8ZX - Excision of Left Inner Ear, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BE8ZZ - Excision of Left Inner Ear, Via Natural or Artificial Opening Endoscopic

  • 09BF0ZX - Excision of Right Eustachian Tube, Open Approach, Diagnostic

  • 09BF0ZZ - Excision of Right Eustachian Tube, Open Approach

  • 09BF3ZX - Excision of Right Eustachian Tube, Percutaneous Approach, Diagnostic

  • 09BF3ZZ - Excision of Right Eustachian Tube, Percutaneous Approach

  • 09BF4ZX - Excision of Right Eustachian Tube, Percutaneous Endoscopic Approach, Diagnostic

  • 09BF4ZZ - Excision of Right Eustachian Tube, Percutaneous Endoscopic Approach

  • 09BF7ZX - Excision of Right Eustachian Tube, Via Natural or Artificial Opening, Diagnostic

  • 09BF7ZZ - Excision of Right Eustachian Tube, Via Natural or Artificial Opening

  • 09BF8ZX - Excision of Right Eustachian Tube, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BF8ZZ - Excision of Right Eustachian Tube, Via Natural or Artificial Opening Endoscopic

  • 09BG0ZX - Excision of Left Eustachian Tube, Open Approach, Diagnostic

  • 09BG0ZZ - Excision of Left Eustachian Tube, Open Approach

  • 09BG3ZX - Excision of Left Eustachian Tube, Percutaneous Approach, Diagnostic

  • 09BG3ZZ - Excision of Left Eustachian Tube, Percutaneous Approach

  • 09BG4ZX - Excision of Left Eustachian Tube, Percutaneous Endoscopic Approach, Diagnostic

  • 09BG4ZZ - Excision of Left Eustachian Tube, Percutaneous Endoscopic Approach

  • 09BG7ZX - Excision of Left Eustachian Tube, Via Natural or Artificial Opening, Diagnostic

  • 09BG7ZZ - Excision of Left Eustachian Tube, Via Natural or Artificial Opening

  • 09BG8ZX - Excision of Left Eustachian Tube, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BG8ZZ - Excision of Left Eustachian Tube, Via Natural or Artificial Opening Endoscopic

  • 09BK0ZX - Excision of Nasal Mucosa and Soft Tissue, Open Approach, Diagnostic

  • 09BK0ZZ - Excision of Nasal Mucosa and Soft Tissue, Open Approach

  • 09BK3ZX - Excision of Nasal Mucosa and Soft Tissue, Percutaneous Approach, Diagnostic

  • 09BK3ZZ - Excision of Nasal Mucosa and Soft Tissue, Percutaneous Approach

  • 09BK4ZX - Excision of Nasal Mucosa and Soft Tissue, Percutaneous Endoscopic Approach, Diagnostic

  • 09BK4ZZ - Excision of Nasal Mucosa and Soft Tissue, Percutaneous Endoscopic Approach

  • 09BK8ZX - Excision of Nasal Mucosa and Soft Tissue, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BK8ZZ - Excision of Nasal Mucosa and Soft Tissue, Via Natural or Artificial Opening Endoscopic

  • 09BKXZX - Excision of Nasal Mucosa and Soft Tissue, External Approach, Diagnostic

  • 09BKXZZ - Excision of Nasal Mucosa and Soft Tissue, External Approach

  • 09BL0ZX - Excision of Nasal Turbinate, Open Approach, Diagnostic

  • 09BL0ZZ - Excision of Nasal Turbinate, Open Approach

  • 09BL3ZX - Excision of Nasal Turbinate, Percutaneous Approach, Diagnostic

  • 09BL3ZZ - Excision of Nasal Turbinate, Percutaneous Approach

  • 09BL4ZX - Excision of Nasal Turbinate, Percutaneous Endoscopic Approach, Diagnostic

  • 09BL4ZZ - Excision of Nasal Turbinate, Percutaneous Endoscopic Approach

  • 09BL7ZX - Excision of Nasal Turbinate, Via Natural or Artificial Opening, Diagnostic

  • 09BL7ZZ - Excision of Nasal Turbinate, Via Natural or Artificial Opening

  • 09BL8ZX - Excision of Nasal Turbinate, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BL8ZZ - Excision of Nasal Turbinate, Via Natural or Artificial Opening Endoscopic

  • 09BM0ZX - Excision of Nasal Septum, Open Approach, Diagnostic

  • 09BM0ZZ - Excision of Nasal Septum, Open Approach

  • 09BM3ZX - Excision of Nasal Septum, Percutaneous Approach, Diagnostic

  • 09BM3ZZ - Excision of Nasal Septum, Percutaneous Approach

  • 09BM4ZX - Excision of Nasal Septum, Percutaneous Endoscopic Approach, Diagnostic

  • 09BM4ZZ - Excision of Nasal Septum, Percutaneous Endoscopic Approach

  • 09BM8ZX - Excision of Nasal Septum, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BM8ZZ - Excision of Nasal Septum, Via Natural or Artificial Opening Endoscopic

  • 09BN0ZX - Excision of Nasopharynx, Open Approach, Diagnostic

  • 09BN0ZZ - Excision of Nasopharynx, Open Approach

  • 09BN3ZX - Excision of Nasopharynx, Percutaneous Approach, Diagnostic

  • 09BN3ZZ - Excision of Nasopharynx, Percutaneous Approach

  • 09BN4ZX - Excision of Nasopharynx, Percutaneous Endoscopic Approach, Diagnostic

  • 09BN4ZZ - Excision of Nasopharynx, Percutaneous Endoscopic Approach

  • 09BN7ZX - Excision of Nasopharynx, Via Natural or Artificial Opening, Diagnostic

  • 09BN7ZZ - Excision of Nasopharynx, Via Natural or Artificial Opening

  • 09BN8ZX - Excision of Nasopharynx, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BN8ZZ - Excision of Nasopharynx, Via Natural or Artificial Opening Endoscopic

  • 09BP0ZX - Excision of Accessory Sinus, Open Approach, Diagnostic

  • 09BP0ZZ - Excision of Accessory Sinus, Open Approach

  • 09BP3ZX - Excision of Accessory Sinus, Percutaneous Approach, Diagnostic

  • 09BP3ZZ - Excision of Accessory Sinus, Percutaneous Approach

  • 09BP4ZX - Excision of Accessory Sinus, Percutaneous Endoscopic Approach, Diagnostic

  • 09BP4ZZ - Excision of Accessory Sinus, Percutaneous Endoscopic Approach

  • 09BP8ZX - Excision of Accessory Sinus, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BP8ZZ - Excision of Accessory Sinus, Via Natural or Artificial Opening Endoscopic

  • 09BQ0ZX - Excision of Right Maxillary Sinus, Open Approach, Diagnostic

  • 09BQ0ZZ - Excision of Right Maxillary Sinus, Open Approach

  • 09BQ3ZX - Excision of Right Maxillary Sinus, Percutaneous Approach, Diagnostic

  • 09BQ3ZZ - Excision of Right Maxillary Sinus, Percutaneous Approach

  • 09BQ4ZX - Excision of Right Maxillary Sinus, Percutaneous Endoscopic Approach, Diagnostic

  • 09BQ4ZZ - Excision of Right Maxillary Sinus, Percutaneous Endoscopic Approach

  • 09BQ8ZX - Excision of Right Maxillary Sinus, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BQ8ZZ - Excision of Right Maxillary Sinus, Via Natural or Artificial Opening Endoscopic

  • 09BR0ZX - Excision of Left Maxillary Sinus, Open Approach, Diagnostic

  • 09BR0ZZ - Excision of Left Maxillary Sinus, Open Approach

  • 09BR3ZX - Excision of Left Maxillary Sinus, Percutaneous Approach, Diagnostic

  • 09BR3ZZ - Excision of Left Maxillary Sinus, Percutaneous Approach

  • 09BR4ZX - Excision of Left Maxillary Sinus, Percutaneous Endoscopic Approach, Diagnostic

  • 09BR4ZZ - Excision of Left Maxillary Sinus, Percutaneous Endoscopic Approach

  • 09BR8ZX - Excision of Left Maxillary Sinus, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BR8ZZ - Excision of Left Maxillary Sinus, Via Natural or Artificial Opening Endoscopic

  • 09BS0ZX - Excision of Right Frontal Sinus, Open Approach, Diagnostic

  • 09BS0ZZ - Excision of Right Frontal Sinus, Open Approach

  • 09BS3ZX - Excision of Right Frontal Sinus, Percutaneous Approach, Diagnostic

  • 09BS3ZZ - Excision of Right Frontal Sinus, Percutaneous Approach

  • 09BS4ZX - Excision of Right Frontal Sinus, Percutaneous Endoscopic Approach, Diagnostic

  • 09BS4ZZ - Excision of Right Frontal Sinus, Percutaneous Endoscopic Approach

  • 09BS8ZX - Excision of Right Frontal Sinus, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BS8ZZ - Excision of Right Frontal Sinus, Via Natural or Artificial Opening Endoscopic

  • 09BT0ZX - Excision of Left Frontal Sinus, Open Approach, Diagnostic

  • 09BT0ZZ - Excision of Left Frontal Sinus, Open Approach

  • 09BT3ZX - Excision of Left Frontal Sinus, Percutaneous Approach, Diagnostic

  • 09BT3ZZ - Excision of Left Frontal Sinus, Percutaneous Approach

  • 09BT4ZX - Excision of Left Frontal Sinus, Percutaneous Endoscopic Approach, Diagnostic

  • 09BT4ZZ - Excision of Left Frontal Sinus, Percutaneous Endoscopic Approach

  • 09BT8ZX - Excision of Left Frontal Sinus, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BT8ZZ - Excision of Left Frontal Sinus, Via Natural or Artificial Opening Endoscopic

  • 09BU0ZX - Excision of Right Ethmoid Sinus, Open Approach, Diagnostic

  • 09BU0ZZ - Excision of Right Ethmoid Sinus, Open Approach

  • 09BU3ZX - Excision of Right Ethmoid Sinus, Percutaneous Approach, Diagnostic

  • 09BU3ZZ - Excision of Right Ethmoid Sinus, Percutaneous Approach

  • 09BU4ZX - Excision of Right Ethmoid Sinus, Percutaneous Endoscopic Approach, Diagnostic

  • 09BU4ZZ - Excision of Right Ethmoid Sinus, Percutaneous Endoscopic Approach

  • 09BU8ZX - Excision of Right Ethmoid Sinus, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BU8ZZ - Excision of Right Ethmoid Sinus, Via Natural or Artificial Opening Endoscopic

  • 09BV0ZX - Excision of Left Ethmoid Sinus, Open Approach, Diagnostic

  • 09BV0ZZ - Excision of Left Ethmoid Sinus, Open Approach

  • 09BV3ZX - Excision of Left Ethmoid Sinus, Percutaneous Approach, Diagnostic

  • 09BV3ZZ - Excision of Left Ethmoid Sinus, Percutaneous Approach

  • 09BV4ZX - Excision of Left Ethmoid Sinus, Percutaneous Endoscopic Approach, Diagnostic

  • 09BV4ZZ - Excision of Left Ethmoid Sinus, Percutaneous Endoscopic Approach

  • 09BV8ZX - Excision of Left Ethmoid Sinus, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BV8ZZ - Excision of Left Ethmoid Sinus, Via Natural or Artificial Opening Endoscopic

  • 09BW0ZX - Excision of Right Sphenoid Sinus, Open Approach, Diagnostic

  • 09BW0ZZ - Excision of Right Sphenoid Sinus, Open Approach

  • 09BW3ZX - Excision of Right Sphenoid Sinus, Percutaneous Approach, Diagnostic

  • 09BW3ZZ - Excision of Right Sphenoid Sinus, Percutaneous Approach

  • 09BW4ZX - Excision of Right Sphenoid Sinus, Percutaneous Endoscopic Approach, Diagnostic

  • 09BW4ZZ - Excision of Right Sphenoid Sinus, Percutaneous Endoscopic Approach

  • 09BW8ZX - Excision of Right Sphenoid Sinus, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BW8ZZ - Excision of Right Sphenoid Sinus, Via Natural or Artificial Opening Endoscopic

  • 09BX0ZX - Excision of Left Sphenoid Sinus, Open Approach, Diagnostic

  • 09BX0ZZ - Excision of Left Sphenoid Sinus, Open Approach

  • 09BX3ZX - Excision of Left Sphenoid Sinus, Percutaneous Approach, Diagnostic

  • 09BX3ZZ - Excision of Left Sphenoid Sinus, Percutaneous Approach

  • 09BX4ZX - Excision of Left Sphenoid Sinus, Percutaneous Endoscopic Approach, Diagnostic

  • 09BX4ZZ - Excision of Left Sphenoid Sinus, Percutaneous Endoscopic Approach

  • 09BX8ZX - Excision of Left Sphenoid Sinus, Via Natural or Artificial Opening Endoscopic, Diagnostic

  • 09BX8ZZ - Excision of Left Sphenoid Sinus, Via Natural or Artificial Opening Endoscopic