Name of the Procedure:

Sinusotomy, maxillary (antrotomy); intranasal

Summary

A sinusotomy, specifically targeted at the maxillary sinuses and performed intranasally, involves creating an opening into the maxillary sinus through the nasal passage. This allows for the drainage and treatment of sinus issues through the nostrils without an external incision.

Purpose

This procedure is intended to address chronic sinus infections or blockages within the maxillary sinuses. The goal is to improve sinus drainage, alleviate symptoms such as pain and pressure, and reduce the frequency of sinus infections.

Indications

• Persistent maxillary sinus infections unresponsive to medication
• Chronic sinusitis causing facial pain or pressure
• Nasal obstruction due to polyps or other blockages
• Recurrent acute sinusitis

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Pre-procedure diagnostic tests may include a CT scan of the sinuses.
• Adjustments to medications, especially blood thinners, as advised by the doctor.
• Nasal decongestants or sprays may be prescribed preoperatively.

Procedure Description

1. The patient is given local or general anesthesia to ensure comfort.
2. A nasal endoscope is inserted into the nostril to visualize the sinus opening.
3. Specialized surgical instruments are used to remove obstructions or to enlarge the natural opening of the maxillary sinus.
4. Any infected or inflamed tissue may be cleared out.
5. The nasal endoscope and instruments are then removed.

Duration

The procedure typically takes 30 minutes to 1 hour.

Setting

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

Personnel

• ENT (Ear, Nose, and Throat) surgeon
• Surgical nurses
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection
• Bleeding
• Nasal congestion or dryness
• Injury to adjacent structures, such as the eyes
• Rare risks include cerebrospinal fluid leak

Benefits

• Relief from chronic sinus symptoms
• Improved sinus drainage
• Reduction in the frequency of sinus infections
• Enhanced quality of life due to alleviation of symptoms

Recovery

• Patients may experience mild discomfort or nasal congestion post-procedure.
• Pain management may involve over-the-counter pain medications.
• Saline nasal sprays are often recommended to keep nasal passages moist.
• Most patients can resume normal activities within a few days.
• Follow-up appointments are necessary to monitor healing and progress.

Alternatives

• Medical management with antibiotics and nasal corticosteroids
• Balloon sinuplasty, a less invasive procedure to dilate the sinus openings
• Functional endoscopic sinus surgery (FESS), a more extensive surgical option

Patient Experience

Patients may feel slight pressure during the procedure if under local anesthesia. Post-operatively, there might be mild discomfort, similar to having a congested nose. Effective pain management and saline nasal sprays will aid in a comfortable recovery.