Nasal/sinus endoscopy, surgical; with concha bullosa resection
CPT4 code
Name of the Procedure:
Nasal/sinus endoscopy, surgical; with concha bullosa resection
Summary
This procedure involves using an endoscope to visually examine and surgically treat issues in the nasal passages and sinus cavities, specifically focusing on removing a concha bullosa, which is a pneumatized (air-filled) cavity within the nasal turbinates.
Purpose
The primary purpose is to alleviate nasal obstruction and improve airflow caused by a concha bullosa. This condition can contribute to chronic sinusitis, headaches, and breathing difficulties. The goal is to restore normal nasal function and reduce related symptoms.
Indications
- Chronic nasal congestion or blockage
- Recurrent sinus infections
- Persistent headaches or facial pain
- Difficulty breathing through the nose Patients typically need to have these symptoms persist despite conservative treatments such as medications.
Preparation
- Patients may need to fast for several hours before the procedure.
- Certain medications might need to be adjusted or stopped.
- A thorough medical evaluation, including a nasal examination and imaging studies like a CT scan, is typically required.
Procedure Description
- The patient is given local or general anesthesia.
- An endoscope, a thin, flexible tube with a light and camera, is inserted into the nasal passages.
- Surgical instruments are used alongside the endoscope to remove the concha bullosa and any obstructive tissue.
- The area is carefully examined to ensure clear nasal pathways.
- Bleeding is controlled, and the nasal cavity is sometimes packed with material to support healing.
Duration
The procedure typically takes about 30 minutes to an hour, depending on complexity.
Setting
The procedure is usually performed in an outpatient surgical center or hospital.
Personnel
- ENT (Ear, Nose, and Throat) surgeon
- Surgical nurses
- Anesthesiologist (if general anesthesia is used)
Risks and Complications
- Bleeding
- Infection
- Adhesions or scar tissue formation
- Changes in sense of smell
- Rare risks include damage to surrounding structures like the eye or skull base
Benefits
- Improved nasal airflow
- Reduction in sinus infections
- Alleviation of associated headaches
- Enhanced overall breathing function Benefits are typically noticed within a few weeks following the procedure.
Recovery
- Patients usually go home the same day.
- Nasal packing, if used, is removed within a few days.
- Avoid strenuous activities for at least a week.
- Follow-up appointments are necessary to monitor healing.
- Pain and discomfort are managed with prescribed medications.
Alternatives
- Medical management with decongestants, antihistamines, or nasal sprays.
- Balloon sinuplasty, a less invasive procedure.
- Observation and monitoring in less severe cases. Each alternative has its own set of benefits and drawbacks, which should be discussed with the healthcare provider.
Patient Experience
- Mild discomfort and nasal stuffiness are common post-procedure.
- Patients may feel a sense of nasal congestion due to swelling and packing.
- Pain is generally manageable with medications, and full recovery typically occurs within a few weeks.
- Regular follow-up visits are important to ensure proper healing and to address any complications promptly.