Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy
CPT4 code
Name of the Procedure:
Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy
Summary
This surgical procedure involves the use of an endoscope to visualize and operate within the nasal passages and sinus cavities to remove diseased tissue from the ethmoid sinuses and access the sphenoid sinus.
Purpose
This procedure is performed to treat chronic sinusitis, nasal polyps, and other sinus-related issues. The goal is to improve sinus drainage and alleviate symptoms such as congestion, pain, and infection.
Indications
- Chronic sinusitis unresponsive to medication
- Nasal polyps obstructing nasal passages
- Recurrent sinus infections
- Sinus-related headaches
- Impaired sense of smell
Preparation
- Patients may need to fast for several hours before the procedure.
- Adjustments to medications, especially blood thinners, may be necessary.
- Pre-operative imaging, like a CT scan, to assess sinus anatomy.
Procedure Description
- The patient is given general anesthesia.
- An endoscope is inserted into the nasal cavity to visualize the sinus passages.
- Surgical instruments are used to remove the diseased tissue from the ethmoid sinuses.
- A sphenoidotomy is performed to open the sphenoid sinus for better drainage.
- The procedure is carefully monitored with the endoscope to ensure precision and minimize bleeding.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
This procedure is usually performed in a hospital or surgical center.
Personnel
- ENT (Ear, Nose, and Throat) surgeon
- Anesthesiologist
- Surgical nurse
Risks and Complications
- Bleeding
- Infection
- Damage to surrounding tissues, including the eye or brain
- Persistent symptoms or recurrence
- Anesthesia-related complications
Benefits
- Relief from chronic sinusitis symptoms
- Improved nasal breathing
- Reduced frequency of sinus infections
- Enhanced sense of smell
- Benefits are often realized within a few weeks post-surgery.
Recovery
- Patients may need to rest for a few days post-procedure.
- Nasal packing may be used to control bleeding.
- Avoid strenuous activities and follow specific nasal care routines.
- Follow-up appointments with the surgeon are critical for optimal recovery.
- Recovery time varies but generally spans 1 to 2 weeks.
Alternatives
- Medical management with antibiotics or steroids
- Balloon sinuplasty (a less invasive option for some patients)
- Continued monitoring and symptomatic treatment
Patient Experience
Patients will be under anesthesia during the procedure and will not feel pain. Post-operatively, they may experience some discomfort, nasal congestion, mild bleeding, and will need to follow care instructions for optimal recovery. Pain management strategies will be provided to ensure comfort.