Name of the Procedure:

Ethmoidectomy; intranasal, anterior (also known as Anterior Ethmoid Sinus Surgery or Anterior Ethmoidectomy).

Summary

An anterior ethmoidectomy is a surgical procedure that involves the removal of part or all of the anterior ethmoid sinuses, which are small air cells located between the nose and eyes. This is done through the nasal passages without external incisions.

Purpose

The procedure is primarily conducted to treat chronic sinusitis or nasal polyps that are not responsive to medical treatment. It helps to improve sinus drainage and alleviate symptoms such as nasal congestion, facial pain, and sinus infections.

Indications

• Chronic or recurrent sinus infections.
• Nasal polyps or other growths obstructing the sinus pathways.
• Headaches and facial pain due to ethmoid sinus issues.
• Sinus congestion unresponsive to medications.

Preparation

• Patients are usually advised to fast for at least 6-8 hours before the procedure.
• Avoid certain medications, such as blood thinners, as advised by the doctor.
• Preoperative imaging studies, like CT scans, may be required to assess the sinuses.

Procedure Description

1. The patient is put under general anesthesia for comfort and to ensure no movement during the surgery.
2. A nasal endoscope—a thin, flexible tube with a camera—is inserted into the nasal passage to visualize the sinuses.
3. Specialized surgical instruments are used to remove the diseased or obstructive tissue from the anterior ethmoid sinuses.
4. The area is carefully cleaned, and any bleeding is controlled.
5. The nasal endoscope is removed, and the nasal passages are packed if necessary to minimize postoperative bleeding.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity.

Setting

Anterior ethmoidectomy is usually performed in a hospital setting or a specialized outpatient surgical center.

Personnel

The procedure involves:

• An otolaryngologist (ENT surgeon) who performs the surgery.
• An anesthesiologist who administers and monitors anesthesia.
• Surgical nurses and operating room staff for assistance.

Risks and Complications

Common Risks:

• Bleeding
• Infection
• Nasal obstruction

Rare Complications:

• Damage to the eye or vision changes
• Cerebrospinal fluid leak
• Persistent sinus infections

Benefits

• Improved sinus drainage and airflow.
• Reduction in the frequency and severity of sinus infections.
• Relief from nasal congestion and facial pain.
• Improved overall quality of life.

Recovery

• Patients may experience nasal congestion and mild discomfort for a few days.
• Pain and antibiotics may be prescribed to manage pain and prevent infection.
• Avoid strenuous activities for at least a week.
• Follow-up appointments are necessary to monitor healing and remove any nasal packing.

Alternatives

• Medical therapy (e.g., antibiotics, nasal corticosteroids).
• Balloon sinuplasty (a less invasive alternative with quicker recovery but not suitable for all cases).
• Endoscopic sinus surgery targeting other sinus areas.

Patient Experience

During the procedure, patients are under general anesthesia and will not feel anything. Postoperatively, some swelling, congestion, and mild pain are expected. Pain relief measures are provided, and over-the-counter pain medications might be recommended. Follow-up care involves monitoring, removing any packing, and possibly additional saline nasal irrigations to aid healing.