Name of the Procedure:

Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus

Summary

In this surgical procedure, a doctor uses an endoscope to view and access the maxillary sinus through the nasal passages. They then create an opening in the maxillary sinus (antrostomy) and remove any problematic tissue, which may include polyps, infected tissue, or other blockages.

Purpose

The procedure addresses chronic sinus infections, nasal obstructions, or the presence of abnormal tissue in the maxillary sinus. The goal is to improve sinus drainage, alleviate symptoms, and prevent future infections.

Indications

• Chronic sinusitis unresponsive to medical treatment
• Nasal polyps
• Tumors or abnormal growths in the maxillary sinus
• Recurring sinus infections
• Nasal obstructions causing breathing difficulties

Preparation

• Fasting for a specified period before the procedure, usually starting from the midnight before surgery.
• Adjusting or pausing certain medications, particularly blood thinners.
• Diagnostic imaging such as a CT scan to evaluate the sinus anatomy.
• Pre-operative consultation for anesthesia evaluation.

Procedure Description

1. The patient is placed under general anesthesia or local anesthesia with sedation.
2. An endoscope is inserted into the nasal cavity to visualize the nasal and sinus passages.
3. Specialized instruments are used to create an opening (antrostomy) in the maxillary sinus.
4. The surgeon removes any abnormal or infected tissue.
5. The area is examined to ensure all necessary tissue has been removed, and the sinus is left with an improved drainage pathway.
6. The procedure is completed and the patient is moved to recovery.

Duration

The procedure typically takes about 1-2 hours, but this can vary depending on the complexity of the case.

Setting

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

Personnel

• ENT (Ear, Nose, and Throat) surgeon
• Anesthesiologist
• Surgical nurses
• Assistants

Risks and Complications

• Bleeding
• Infection
• Damage to surrounding structures (e.g., eye socket, brain)
• Recurrence of sinus congestion or infection
• Persistent pain or discomfort
• Adverse reactions to anesthesia

Benefits

• Relief from chronic sinusitis symptoms
• Improved nasal breathing and sinus drainage
• Reduced frequency and severity of sinus infections
• Overall improvement in quality of life

Recovery

• Immediate post-operative monitoring for complications
• Instructions on nasal care, including saline rinses to keep the area clean
• Pain management with prescribed medications
• Avoiding strenuous activities for at least a week
• Follow-up appointments to monitor healing

Alternatives

• Medical management with antibiotics, nasal sprays, and decongestants
• Balloon sinuplasty, a less invasive procedure to open sinus passageways
• Conservative management such as nasal irrigation and lifestyle modifications

Patient Experience

Patients usually report discomfort and mild pain post-surgery, which is manageable with prescribed pain medications. There may be nasal congestion and mild bleeding initially. Full recovery typically takes a few weeks, with significant improvements noted within the first few days to a week. Pain management and nasal care instructions play a key role in patient comfort and recovery.