30117 Excision or destruction (eg, laser), intranasal lesion; internal approach

Name of the Procedure:

Excision or Destruction (e.g., Laser), Intranasal Lesion, Internal Approach

Summary

This procedure involves removing or destroying abnormal tissue or lesions within the nasal cavity using methods such as laser technology. It is performed internally without external incisions.

Purpose

The procedure aims to treat intranasal lesions that may cause nasal obstruction, bleeding, or other symptoms. Removing these lesions can improve nasal breathing, reduce symptoms, and prevent potential complications.

Indications

• Nasal obstruction or difficulty breathing through the nose
• Recurrent nosebleeds
• Presence of visible lesions or growths in the nasal cavity
• Chronic nasal congestion not responsive to other treatments
• Suspicion of malignancy in nasal lesions

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Medications, especially blood thinners, may need to be adjusted.
• Pre-procedure imaging studies like CT or MRI scans may be required to assess the lesion.
• Nasal irrigation or use of nasal steroids may be recommended pre-procedure.

Procedure Description

1. The patient is positioned appropriately, and local or general anesthesia is administered.
2. Nasal endoscope is inserted into the nasal cavity to visualize the lesion.
3. Using specialized instruments such as a laser, the surgeon excises or destroys the lesion.
4. Hemostasis is achieved to control bleeding.
5. The tools are removed, and the nasal cavity is inspected for any remaining abnormal tissue or complications.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity and size of the lesion.

Setting

The procedure is usually performed in an outpatient surgical center, hospital operating room, or specialized clinic.

Personnel

• Otolaryngologist (ENT specialist) or surgeon
• Anesthesiologist (if general anesthesia is used)
• Surgical nurses
• Technicians to operate specialized equipment (e.g., laser)

Risks and Complications

• Bleeding
• Infection
• Scarring within the nasal cavity
• Pain or discomfort post-procedure
• Rare risk of damage to surrounding nasal structures
• Potential for recurrence of the lesion

Benefits

• Relief from nasal obstruction and improved breathing
• Reduction or elimination of nosebleeds
• Rapid resolution of symptoms often within days
• Minimally invasive with no external scars

Recovery

• Patients may experience some nasal congestion and minor bleeding post-procedure.
• Pain is generally managed with over-the-counter pain relievers.
• Avoid strenuous activities and nose blowing for a few days to prevent complications.
• Follow-up appointments are necessary to monitor healing and ensure no recurrence of the lesion.

Alternatives

• Medical management with nasal steroids or decongestants
• Traditional surgical excision through an external approach, which may involve more extensive surgery and longer recovery
• Monitoring without immediate intervention, depending on the lesion's nature and symptoms

Patient Experience

During the procedure, patients under general anesthesia will be asleep and feel nothing, while those under local anesthesia may feel some pressure but no pain. Post-procedure, mild discomfort, congestion, and minor bleeding are common. Pain is usually manageable with medications and resolves within a few days.