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Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)

CPT4 code

Name of the Procedure:

Nasal/Sinus Endoscopy with Ethmoidectomy; Partial (Anterior)

Summary

This surgical procedure involves using an endoscope to visualize and remove diseased tissue from the ethmoid sinus, which is part of the sinuses located between the nose and the eyes. The surgery is minimally invasive and focuses on the anterior (front) part of the ethmoid sinus.

Purpose

The procedure aims to alleviate symptoms caused by chronic sinus infections, inflammation, or nasal polyps. It helps improve sinus drainage, reduce infections, and alleviate nasal congestion.

Indications

  • Chronic sinusitis not responding to medical treatment
  • Recurrent sinus infections
  • Nasal polyps obstructing sinus drainage
  • Difficulty breathing through the nose due to sinus blockage

Preparation

  • Fasting for at least 6-8 hours before the procedure
  • Adjustments to medications, particularly blood thinners, as directed by the doctor
  • Pre-operative imaging studies like CT or MRI scans of the sinuses
  • Pre-surgery consultation for anesthesia assessment

Procedure Description

  1. The patient is administered either local or general anesthesia.
  2. An endoscope, a thin flexible tube with a camera, is inserted into the nostrils to visualize the nasal passages and sinuses.
  3. Specialized surgical instruments are used to remove diseased or inflamed tissue from the anterior (front) part of the ethmoid sinus.
  4. The area is carefully examined for any remaining obstructions.
  5. The instruments and endoscope are removed, and the nasal passages are gently packed if necessary to control bleeding.

Duration

Typically, the procedure lasts between 1 to 2 hours.

Setting

Performed in a hospital or an outpatient surgical center.

Personnel

  • ENT (Ear, Nose, and Throat) Surgeon
  • Anesthesiologist
  • Surgical Nurse
  • Operating Room Technician

Risks and Complications

  • Infection
  • Bleeding
  • Recurrence of sinusitis
  • Damage to surrounding structures, such as the eye or skull base
  • Anesthetic complications

Benefits

  • Relief from chronic sinusitis symptoms
  • Improved nasal airflow and drainage
  • Reduced frequency of sinus infections
  • Enhanced quality of life

Recovery

  • Mild discomfort or nasal congestion is common post-procedure.
  • Pain management with prescribed medications.
  • Nasal saline rinses to keep the sinus passages clear.
  • Avoid strenuous activities for a few days.
  • Follow-up appointments to monitor healing.

Alternatives

  • Medication management with antibiotics, steroids, or nasal sprays.
  • Balloon sinuplasty, a less invasive procedure to dilate the sinus openings.
  • Continued observation in less severe cases.

Patient Experience

During the procedure, patients under general anesthesia will be asleep and feel no pain. Those with local anesthesia may feel mild pressure. Post-surgery, patients can expect some nasal congestion, minor pain, and blood-tinged nasal discharge. Pain is typically managed with medications, and most patients can resume normal activities within a week.

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