31238 Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage

Name of the Procedure:

Nasal/Sinus Endoscopy, Surgical; with Control of Nasal Hemorrhage (also known as Functional Endoscopic Sinus Surgery or FESS with Hemostasis)

Summary

This procedure involves the use of an endoscope to look inside the nasal passages and sinuses. It is performed to stop bleeding within these areas by medical or surgical means.

Purpose

The procedure addresses severe or persistent nasal hemorrhage (nosebleeds). The goal is to locate the source of bleeding and control it, which helps to prevent further bleeding and associated complications.

Indications

• Recurrent or severe nosebleeds that do not respond to conventional treatments
• Hemorrhage stemming from sinus surgery complications
• Nosebleeds caused by trauma or specific medical conditions like hypertension or clotting disorders

Preparation

• Patients may be advised to fast for a certain period before the procedure.
• Blood tests or imaging studies (e.g., CT scan) may be conducted beforehand.
• Patients may need to adjust medications, especially blood thinners, after consulting with their doctor.

Procedure Description

1. The patient will be given local or general anesthesia, depending on the severity of the hemorrhage and overall health.
2. An endoscope, a thin tube with a camera, is inserted into the nasal passage.
3. The surgeon uses the camera to locate the source of the bleeding.
4. Various techniques, such as cauterization, application of topical agents, or surgical devices, are employed to control the bleeding.
5. The endoscope is removed, and any additional treatments, like nasal packing, might be applied.

Duration

The procedure typically takes around 30 minutes to an hour, depending on complexity.

Setting

Performed in a hospital's operating room or an outpatient surgical center.

Personnel

• ENT (Ear, Nose, and Throat) Surgeon
• Anesthesiologist
• Surgical nurses
• Medical assistants

Risks and Complications

• Mild to moderate pain or discomfort
• Infection
• Recurrence of bleeding
• Adverse reactions to anesthesia
• Rarely, damage to surrounding tissues or structures

Benefits

• Immediate control of nasal bleeding
• Reduced risk of further hemorrhage
• Improved quality of life and relief from associated symptoms

Recovery

• Patients may need to stay in the recovery room for monitoring.
• Nasal packing might be present and should be kept dry.
• Follow-up appointments will be scheduled to monitor healing.
• Patients should avoid strenuous activity and follow specific care instructions provided by their healthcare provider.

Alternatives

• Non-surgical methods such as nasal sprays, cauterization without endoscopy, or packing.
• Pros include less invasive options with no anesthesia; cons include potential recurrence or less effective hemorrhage control.

Patient Experience

Patients may experience some discomfort and congestion immediately after the procedure. Pain management typically includes over-the-counter pain relievers or prescribed medications. Most patients are back to normal activities within a week, but they should follow all postoperative care instructions for optimal recovery.