Which of the following is the very first step in Functional endoscopic sinus surgery?
Surgical technique

After suitable vasoconstriction using cocaine or ephedrine, the middle turbinate is identified. This is the most important landmark for the procedure. On the lateral wall of the nose at the level of the anterior end of the middle turbinate lies the uncinate process. This is removed, exposing the ethmoid bulla and the opening called the hiatus semilunaris, into which the frontal and maxillary sinuses drain.
The anterior ethmoid air cells are then opened, allowing better ventilation but leaving the bone covered with mucosa. Following this, the maxillary ostium is inspected and, if obstructed, opened by means of a middle meatal antrostomy. This minimal surgery will often be sufficient to greatly improve the function of the osteomeatal complex and therefore provide better ventilation of the maxillary, ethmoid and frontal sinuses.
Occasionally the CT scan shows disease in the posterior ethmoids and the sphenoid sinus. It is then necessary to continue further into these sinuses. However, in most cases of sinusitis, the inflammation is confined to the osteomeatal complex and the anterior ethmoids.
Opening of bulla ethmoidalis
Uncinectomy
Middle meatal antrostomy
Middle turbinectomy