31288 Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus

Name of the Procedure:

Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus

Summary

In this procedure, a surgeon uses an endoscope to access the sphenoid sinus through the nasal passages and perform a sphenoidotomy. The surgeon then removes tissue from the sphenoid sinus, which may be causing blockages, infections, or other issues.

Purpose

This procedure addresses conditions such as chronic sinusitis, sinus infections, polyps, tumors, or other growths in the sphenoid sinus. The goal is to remove problematic tissue, relieve symptoms like sinus congestion and headaches, and improve sinus drainage and airflow.

Indications

• Recurrent or chronic sinus infections
• Nasal polyps
• Fungal sinusitis
• Mucoceles or cysts in the sphenoid sinus
• Suspicion or diagnosis of sinus tumors
• A CT scan or MRI showing blockage or growths in the sphenoid sinus

Preparation

• Patients are usually advised to fast for 6-8 hours before the procedure.
• Blood tests or imaging studies like a CT scan may be required.
• Review current medications with your doctor, as some may need to be stopped or adjusted.
• Avoid taking aspirin and other blood-thinning medications as directed.

Procedure Description

1. The patient is given local or general anesthesia to ensure comfort.
2. An endoscope, a thin tube with a camera, is inserted into the nasal passage to reach the sphenoid sinus.
3. The surgeon uses small instruments to perform a sphenoidotomy, creating an opening in the sphenoid sinus for better access.
4. Unwanted tissue, such as polyps or infected tissue, is removed from the sphenoid sinus.
5. Hemostasis is ensured, and the instruments are carefully withdrawn.
6. The procedure may be supported by image guidance technology for precision.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital or an outpatient surgical center.

Personnel

• Otolaryngologist (ENT surgeon)
• Anesthesiologist or nurse anesthetist
• Surgical nurses and support staff

Risks and Complications

• Bleeding
• Infection
• CSF (cerebrospinal fluid) leak
• Damage to nearby structures, such as the optic nerve
• Anesthesia-related risks
• Scar tissue formation and potential need for revision surgery

Benefits

• Relief from chronic sinus infections and related symptoms
• Improved nasal and sinus airflow
• Reduction in sinus headaches and facial pain
• Lowered risk of further sinus complications

Recovery

• Patients may experience nasal congestion and mild discomfort for a few days.
• Post-procedure care often includes saline rinses and nasal sprays.
• Avoid strenuous activities and follow specific instructions provided by your surgeon.
• Recovery time typically spans 1 to 2 weeks, with follow-up appointments to monitor healing.

Alternatives

• Medical management with antibiotics or nasal steroids
• Balloon sinuplasty
• Traditional open sinus surgery
• Non-surgical treatments (e.g., nasal irrigation, allergy management) Each option has its own risks and benefits, which should be discussed with a healthcare provider.

Patient Experience

Patients might feel pressure or mild discomfort during the procedure if under local anesthesia. Post-procedure, expect some nasal congestion, mild bleeding, and discomfort, which can be managed with prescribed pain medication and saline rinses. Full recovery usually occurs within a couple of weeks, with significant symptom relief noticed shortly afterwards.