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Nasal/sinus endoscopy, surgical, with maxillary antrostomy

CPT4 code

Name of the Procedure:

Nasal/sinus endoscopy, surgical, with maxillary antrostomy

Summary

A nasal/sinus endoscopy with maxillary antrostomy is a surgical procedure performed using an endoscope to visualize and treat issues within the nasal passages and sinuses. It involves creating an opening in the maxillary sinus to improve drainage.

Purpose

This procedure is done to address chronic sinus infections, sinus blockages, or severe inflammation. The goal is to provide relief from sinus symptoms, improve sinus drainage, and prevent recurrent infections.

Indications

  • Chronic sinusitis unresponsive to medical therapy
  • Sinus blockages due to polyps or anatomical abnormalities
  • Recurrent sinus infections
  • Severe inflammation of the sinuses

Preparation

  • Patients may be instructed to fast for a certain period before the procedure.
  • You will need to stop certain medications, such as blood thinners, as advised by your physician.
  • Pre-procedure diagnostic tests, such as CT scans or nasal endoscopy, may be necessary.

Procedure Description

  1. The patient is given either local or general anesthesia.
  2. An endoscope—a thin, flexible tube with a camera—is inserted into the nasal passages.
  3. The surgeon visualizes the sinus cavities and uses specialized instruments to create an opening (antrostomy) in the maxillary sinus.
  4. The opening helps enhance sinus drainage and allows any trapped mucus or pus to be removed.
  5. The endoscope and instruments are then carefully removed.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

This procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

  • Otolaryngologist (ENT surgeon)
  • Anesthesiologist or nurse anesthetist
  • Surgical nurses and technicians

Risks and Complications

  • Bleeding
  • Infection
  • Scarring inside the nasal passages
  • Damage to surrounding structures, such as the eyes
  • Anesthesia-related risks

Benefits

  • Relief from chronic sinusitis symptoms
  • Improved sinus drainage
  • Reduced frequency of sinus infections
  • Better overall nasal function

Recovery

  • Patients may experience mild swelling and discomfort, which can be managed with medications.
  • Nasal packing may be placed to control bleeding and will be removed as directed.
  • Avoid strenuous activities and follow-up with your doctor as recommended.
  • Full recovery typically occurs within a few weeks.

Alternatives

  • Medical management with antibiotics and nasal corticosteroids
  • Balloon sinuplasty
  • Functional endoscopic sinus surgery (FESS)
  • Each alternative has its pros and cons, which should be discussed with your healthcare provider.

Patient Experience

During the procedure, patients under general anesthesia will be asleep and feel no pain. Those with local anesthesia might feel some pressure but no pain. Post-procedure, there may be some nasal congestion, mild pain, and discomfort, all manageable with prescribed medications and care instructions.

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