31233 Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or canine fossa puncture)

Name of the Procedure:

Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or canine fossa puncture). Also known as maxillary sinus endoscopy.

Summary

This diagnostic procedure involves using an endoscope to look inside the nasal passages and maxillary sinuses. The endoscope is inserted through either the inferior meatus (nasal passage) or via a puncture in the canine fossa (upper jaw area).

Purpose

This procedure helps to diagnose issues within the maxillary sinuses, such as infections, blockages, or tumors. The goal is to visually examine the sinus anatomy and gather information that can direct appropriate treatment.

Indications

• Chronic sinusitis unresponsive to standard treatments
• Sinus tumors or growths
• Unexplained nasal blockages
• Recurrent sinus infections
• Preoperative assessment for sinus surgery

Preparation

• Fasting for a few hours before the procedure, if sedation is required.
• Adjustments to any medications as advised by your healthcare provider.
• Pre-procedure diagnostic tests, such as CT scans or X-rays of the sinuses.

Procedure Description

1. Anesthesia: Local anesthesia is administered to numb the nasal passages. In some cases, general anesthesia or sedation might be used.
2. Endoscope Insertion: A thin, flexible tube with a camera (endoscope) is inserted through the nasal passage (via the inferior meatus) or through a small puncture in the upper jaw (canine fossa).
3. Visualization: The doctor examines the sinus cavities for abnormalities, blockages, or infections.
4. Tissue Sampling: If necessary, biopsies or samples of tissue may be taken for further analysis.
5. Endoscope Removal: The endoscope is carefully withdrawn.

Duration

Typically takes about 30 minutes to an hour.

Setting

Performed in an outpatient clinic, ambulatory surgical center, or hospital.

Personnel

• ENT (Ear, Nose, and Throat) specialist or sinus surgeon
• Nursing staff
• Anesthesiologist (if sedation or general anesthesia is used)

Risks and Complications

• Bleeding
• Infection
• Nasal or sinus discomfort
• Damage to nasal structures
• Rarely, complications related to anesthesia

Benefits

• Accurate diagnosis of sinus conditions
• Direct visualization of sinus anatomy
• Ability to take tissue samples for biopsy
• Minimally invasive with a quick recovery time

Recovery

• Post-procedure care includes avoiding strenuous activities for several days.
• Use of saline nasal sprays to keep the nasal passages moist.
• Pain management with over-the-counter pain relievers.
• Follow-up appointments to discuss findings and next steps.

Alternatives

• Sinus X-rays or CT scans (less invasive but do not offer direct visualization)
• Medical therapy such as antibiotics or nasal corticosteroids (for certain conditions)
• Open surgical procedures (more invasive with a longer recovery time)

Patient Experience

• You may feel pressure or mild discomfort during the procedure, especially if under local anesthesia.
• Post-procedure, expect some nasal congestion and minor bleeding.
• Pain management and saline nasal sprays can help with comfort and recovery.