Name of the Procedure:

Ethmoidectomy; extranasal, total

Summary

An ethmoidectomy, extranasal, total is a surgical procedure to remove the ethmoid sinuses, which are air cells located between the nose and the eyes. The procedure is done externally through an incision rather than through the nasal passages.

Purpose

This procedure is generally performed to address chronic sinus infections, nasal polyps, or other conditions affecting the ethmoid sinuses that do not respond to medication. The goal is to alleviate symptoms such as nasal congestion, recurrent infections, and headaches, and to improve overall sinus function.

Indications

• Chronic or recurrent sinusitis.
• Nasal polyps obstructing the sinuses.
• Certain cases of sinus tumors.
• Conditions where medications have failed to provide relief.
• Anatomical issues leading to sinus blockages.

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Certain medications, particularly blood thinners, may need to be paused.
• Pre-operative imaging studies such as a CT scan may be required to map the sinus anatomy.
• A thorough medical history and physical examination will be conducted.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Incision: An external incision is made near the nose or between the eyes.
3. Accessing the Sinuses: The surgeon carefully removes the bone and tissue to access the ethmoid sinuses.
4. Removal of Sinus Tissue: The ethmoid air cells are systematically removed.
5. Closure: The surgical site is then closed with sutures, and packing may be placed in the nasal cavity to support healing and reduce bleeding.

Duration

The procedure typically takes 1 to 2 hours to complete.

Setting

Ethmoidectomy is generally performed in a hospital or surgical center under sterile conditions.

Personnel

• An Otolaryngologist (ENT Surgeon) performs the procedure.
• An Anesthesiologist administers and monitors anesthesia.
• Surgical nurses assist in the operation.

Risks and Complications

• Common Risks: Bleeding, infection, nasal crusting, and temporary nasal obstruction.
• Rare Risks: Damage to surrounding structures such as the eyes or brain, cerebrospinal fluid leaks, and reduced sense of smell.
• Complications are managed with medications, additional procedures, or supportive care as necessary.

Benefits

• Relief from chronic nasal congestion and sinus infections.
• Improved breathing and sinus drainage.
• Enhancement of overall quality of life.
• Benefits are typically realized within a few weeks post-surgery.

Recovery

• Patients may experience nasal packing, swelling, and discomfort initially.
• Pain can be managed with prescribed medications.
• Nasal irrigation and saline sprays are often recommended to promote healing.
• Follow-up appointments are necessary to monitor recovery and remove any nasal packing.
• Full recovery typically takes a few weeks, with most returning to normal activities within 1 to 2 weeks.

Alternatives

• Medical Management: Antibiotics, nasal corticosteroids, and saline irrigation.
• Other Surgical Options: Endoscopic sinus surgery, which is less invasive and performed through the nasal passages.
• Each alternative has its own set of benefits and risks, and the choice depends on the individual patient's condition and anatomy.

Patient Experience

• Under general anesthesia, the patient will be unconscious during the procedure.
• Post-surgery, patients may experience some discomfort, nasal congestion, and mild pain, which can be managed with medications.
• It's essential to follow all post-operative care instructions to ensure a smooth recovery.