Name of the Procedure:

Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus.

Summary

This procedure is a type of sinus surgery where doctors use an endoscope to view and operate within the nasal passages. It involves removing part or all of the ethmoid sinuses and opening the sphenoid sinus to remove tissue.

Purpose

This surgery addresses chronic sinusitis and other related sinus problems that haven't responded to medical treatment. The goal is to improve sinus drainage and alleviate symptoms such as congestion, pain, and infection.

Indications

• Chronic sinusitis
• Sinus polyps
• Fungal sinusitis
• Sinus infections that don't respond to medication
• Anatomical blockages affecting sinus drainage

Preparation

• Fasting for at least 6 hours before the procedure
• Stopping certain medications like blood thinners
• Preoperative imaging tests like CT scans to assess the sinuses
• Informing the doctor about any allergies or medical conditions

Procedure Description

1. Anesthesia, usually general, is administered.
2. An endoscope is inserted into the nasal cavity.
3. Specialized instruments are used to remove inflamed tissue and bone from the ethmoid sinuses.
4. The sphenoid sinus is opened (sphenoidotomy).
5. Any obstructing tissue in the sphenoid sinus is removed.
6. The area is cleaned, and any excessive bleeding is controlled.

Duration

The procedure typically takes 1 to 2 hours.

Setting

The procedure is performed in a hospital or outpatient surgical center.

Personnel

• Otolaryngologist (ENT surgeon)
• Anesthesiologist
• Surgical nurse
• Scrub technician

Risks and Complications

• Bleeding
• Infection
• Damage to surrounding structures (e.g., eye socket or brain)
• Scar tissue formation
• Persistent symptoms or need for additional surgery

Benefits

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

Recovery

• Rest for a few days post-surgery
• Avoid blowing the nose and heavy lifting for at least a week
• Use saline sprays to keep nasal passages moist
• Follow-up appointments to monitor healing
• Full recovery typically takes a few weeks

Alternatives

• Medical management with nasal sprays, antibiotics, and steroids
• Balloon sinuplasty, a less invasive option
• Nasal irrigation and lifestyle modifications

Patient Experience

During the procedure:

• The patient will be asleep under general anesthesia.

After the procedure:

• Expect some nasal congestion and mild discomfort
• Pain can usually be managed with prescribed medication
• Instructions on sleeping with the head elevated to reduce swelling