Name of the Procedure:

Lysis of Intranasal Synechia

Summary

Lysis of intranasal synechia is a minor surgical procedure to remove fibrous bands (synechiae) that form abnormal connections between the inner surfaces of the nasal cavity. This can help restore normal airflow and nasal functionality.

Purpose

The procedure addresses nasal obstruction and breathing difficulties caused by intranasal synechiae. The goal is to eliminate these adhesions to improve nasal patency and overall breathing.

Indications

• Persistent nasal obstruction
• Difficulty breathing through the nose
• Recurrent sinus infections due to blockage
• Prior nasal surgery or trauma leading to synechiae formation

Preparation

• Fasting for at least 6-8 hours before the procedure if general anesthesia is used
• Adjustment of certain medications as advised by the doctor
• Preoperative nasal endoscopy to assess the extent of the synechiae

Procedure Description

1. The patient is positioned comfortably, and local or general anesthesia is administered.
2. A nasal speculum is used to widen the nasal passage.
3. Using a surgical instrument, the synechiae are carefully dissected and removed.
4. The nasal cavity is then inspected to ensure all adhesions are cleared.
5. Nasal packing or a stent may be placed to prevent reformation of synechiae.

Tools Used:

• Nasal speculum
• Surgical scissors or scalpel
• Nasal endoscope
• Nasal packing or stent

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

Performed in an outpatient clinic, surgical center, or hospital operating room.

Personnel

• An otolaryngologist (ENT surgeon)
• Anesthesiologist (if general anesthesia is used)
• Surgical nurse

Risks and Complications

• Bleeding and infection
• Reformation of synechiae
• Scarring or damage to surrounding nasal tissues
• Anesthesia-related complications

Benefits

• Restored normal nasal airflow
• Improved breathing and reduced nasal obstruction
• Decreased risk of recurrent sinus infections

Recovery

• Patients may experience mild discomfort or nasal congestion.
• Instructions for nasal care, including saline rinses and avoiding nose blowing, are given.
• Follow-up appointments to monitor healing.
• Full recovery typically within 1 to 2 weeks, with some restrictions on physical activity.

Alternatives

• Conservative management with nasal sprays or medications
• Balloon sinuplasty
• Endoscopic sinus surgery with different techniques Each alternative has its own benefits and risks, and suitability depends on the specific case.

Patient Experience

Patients might feel some pressure and discomfort during the procedure if under local anesthesia. Post-procedure, there may be mild pain and nasal congestion, which can be managed with prescribed pain relievers and decongestants. Regular follow-up helps ensure successful recovery and management of any concerns.